Whooping Cough and Pregnancy

Whooping Cough and Pregnancy

Pertussis (whooping cough) is caused by the bacterium Bordetella pertussis.boostrix

There is no evidence that if you develop whooping cough in pregnancy your baby will be harmed while it is inside you.

The risk to your baby has to do with once your baby is born. The disease is highly infectious and most serious in babies under the age of 12 months.

In young babies less than six months of age, the symptoms can be severe or life threatening. Some of the complications of whooping cough in young babies include haemorrhage (bleeding), apnoea (stopping breathing for periods of time), pneumonia, Inflammation of the brain, convulsions and coma, permanent brain damage and even death.

What can be done about it?

If you have whooping cough. The antibiotic Erythromycin is recommended for treating whooping cough. But while antibiotics are effective in eliminating B. pertussis from the nasopharynx and so rendering you non-infectious, antibiotics do not alter the clinical course of the illness.

If someone else has whooping cough. If a work colleague has whooping cough and you are not vaccinated then stay away from them as it is a nasty condition to catch. But don’t be concerned you baby will be harmed. This the same advice for being in contact with family members and friends who have whooping cough. After you have your baby then keep your baby away from someone suspected of having whooping cough.

Vaccination

  • Pre-pregnancy A single booster dose of adult formulation pertussis vaccine (dTpa) is recommended for you and your husband / partner when planning a pregnancy. This can be arranged through your GP.
  • In pregnancy There is increasing opinion that you being vaccinated between 28 and 38 weeks of your pregnancy is a good idea. You can arrange this with your GP.

Your antibodies will cross into your baby’s circulation and give your baby protection in initial life, and in particular before your baby has been vaccinated. After 38 weeks the vaccine may not protect your baby from whooping cough, as your body might not have enough time to produce the antibodies before your baby is born.

Clinical trials don’t usually involve pregnant women. For this reason, evidence on safety in pregnancy can be limited. But there is no evidence the vaccine will cause your baby harm.

The Australian Government is cautious and states there is “a potential disadvantage of giving dTpa in the third trimester of pregnancy is that maternal pertussis antibodies may interfere with an infant’s immune response following the primary three-dose DTPa course at two, four and six months of age, a phenomenon referred to as ‘blunting’. However, because correlates of protection are not fully understood, the clinical importance of this is uncertain”.

Your third trimester is also a good time your husband/partner and those in close contact with baby (grandparents, others close family members, carers) to be vaccinated.

  •  After your baby is born (if not already done) for you, your husband/partner and those in close contact with baby (grandparents, others close family members, carers).
  • Your baby should be given doses of vaccine by your GP at two, four and six months of age, with booster doses at four years and 15 to 17 years.

http://www.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-pertussis

http://www.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-4-12

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/whooping-cough-vaccination-pregnant.aspx

Posted by Dr Gary Sykes on -

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