Seroprevalence of rubella in the cord blood of pregnant women and congenital rubella incidence in Nha Trang, Vietnam

Vaccine. 2014 Feb 26;32(10):1192-8. doi: 10.1016/j.vaccine.2013.08.076. Epub 2013 Sep 7.


To investigate susceptibility to and factors associated with rubella infection among pregnant mothers and to estimate the burden of congenital rubella infection (CRI) in Vietnam where rubella-containing vaccine (RCV) is not included in the routine immunization program, we conducted a prospective cohort study in Nha Trang, Vietnam between 2009 and 2010. Rubella-specific immunoglobulin-M and immunoglobulin-G were investigated in cord blood samples by enzyme immunoassay. Corresponding clinical-epidemiological data were analyzed and the national congenital rubella syndrome (CRS) incidence was estimated using modeling. We enrolled 1988 pairs of mothers aged 17-45 years and their newborn babies. No mothers had received RCV. Multivariate analysis revealed that mothers aged 17-24 (aOR 2.5, 95% CI: 1.7-3.8) or 25-34 (1.4, 1.0-2.1) years were more likely to be susceptible than those aged 35-45 years. Overall 28.9% (574/1988, 95% CI: 26.9-30.9%) of mothers were seronegative. The CRI rate was 151 (95% CI: 0-322) per 100,000 live births. Modeling estimated that 3788 babies (95% CI: 3283-4143) were born with CRS annually in Vietnam with an overall CRS incidence of 234 (95% CI: 207-262) cases per 100,000 live births. A substantial proportion of women of childbearing age (WCBA) are at risk of rubella infection during pregnancy and this can result in a high frequency of miscarriage or burden of CRS across Vietnam. Prompt introduction of RCV into national immunization program with catch-up vaccination to children and WCBA will reduce CRI in Vietnam.

Keywords: Congenital rubella syndrome; Cord blood; IgG; IgM; Incidence; Modeling; Seroprevalence; Women of childbearing age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Female
  • Fetal Blood / virology*
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Incidence
  • Infant, Newborn
  • Middle Aged
  • Models, Biological
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Prospective Studies
  • Rubella / epidemiology
  • Rubella Syndrome, Congenital / epidemiology*
  • Rubella Vaccine / administration & dosage
  • Seroepidemiologic Studies
  • Vietnam / epidemiology
  • Young Adult


  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • Rubella Vaccine