RUBELLA INFECTION DURING PREGNANCY IN THE 1985-86 EPIDEMIC - FOLLOW-UP AFTER 7 YEARS

The study covered 310 pregnant women from southern Poland who were exp osed to rubella during the 1985-86 epidemic, none of whom had been vac cinated against rubella. Rubella specific antibodies were detected by hemagglutination - inhibition (HI) tests, and IgM antibodies by enzyme immunoassay (ELISA) (Organon Teknika). Clinical symptoms according to anamnesis were recorded. The consequences of serologically confirmed maternal rubella on the course of pregnancy and on fetal outcome were evaluated. IgM antibodies could be examined in only 10 newborns at del ivery or in the first days of life. After seven years, follow-up studi es of children born to infected mothers were done. The mental developm ent of 14 of these children was evaluated with Terman-Merrill test. Am ong 310 women examined during pregnancy, rubella infection was confirm ed serologically in 46 cases (14.8%). All but 3 of those had clinical symptoms. The course of pregnancy was observed in 36 of the infected m others. Only 5 women (22.7%) who had the infection in the first trimes ter of pregnancy delivered a healthy child. The rate of complications in pregnancy among women infected in the second trimester was lower, a nd 8 (66.7%) bore healthy children. All the children born to mothers i nfected in the third trimester were healthy. Eight of the 10 newborns examined at delivery were IgM positive. Of 29 children congenital rube lla syndrome (CRS) was confirmed in 5 cases, CRS compatible or CRS pos sible in 7 and 3 had congenital infection only confirmed serologically (IgM-positive) without defects or symptoms. Seventheen (58.6%) childr en were found healthy including the 3 who had congenital infection onl y. The mental development of 14 children at age 7 was assessed; 10 cas es (72%) fell within rank II 130-85, and 4 (28%) were of borderline in telligence. The study indicates that congenital rubella is still a ser ious problem in Poland. Immunization was introduced only in 1988-89, f or 13-year-old girls. Women of child- bearing age should be screened f or rubella antibodies and those susceptible to rubella infection shoul d be vaccinated.