Objective: To determine the prevalence of measles seronegativity among
infants younger than 6 months and to ascertain their serologic respon
se to measles vaccine. Design: Cross-sectional measles antibody survey
during the 1989 measles epidemic in Chicago, Ill. Setting: Inner-city
perinatal center. Participants: Two hundred three infants younger tha
n 6 months who had been admitted to the neonatal intensive care unit a
t birth; 130 (64%) of these infants were premature. Transplacental ant
ibody transfer was evaluated in a subset of 89 mother-newborn pairs. I
ntervention: Administration of measles monovalent vaccine to seronegat
ive infants. Measurements/Results: Measles IgG antibody was measured u
sing indirect fluorescent assay. At birth, 19 (38%) of 50 neonates bor
n at less than 37 weeks' gestation had antibody titers that were twofo
ld to fourfold lower than those of their mothers compared with three (
8%) of 39 neonates born at more than 37 weeks' gestation (P<.01). Of t
he 203 study infants, fewer than 4% were seronegative at birth, while
74% of these infants aged 4 to 5 months were seronegative. Univariate
logistic regression analysis indicated that the independent variables
related to seronegativity were as follows: gestational age at birth (P
=.007), chronological age (P<.001), history of having received three o
r more packed red blood cell transfusions (P<.001), and maternal age a
t delivery (P=.001). Multiple logistic regression analysis confirmed t
he association of seronegativity with chronological age (P<.001), gest
ational age (P<.02), and maternal age at delivery (P<.001). Seroconver
sion following administration of the measles vaccine was documented in
11 (79%) of 14 infants. Conclusion: A significant proportion of 4- to
5-month-old infants who had been admitted to the neonatal intensive c
are unit at birth lack measurable measles antibody; this population sh
ould be taken into account when strategies to control measles are cons
idered.