Diphteria, tetanus and acellular pertussis vaccine(TDAP) in pregnancy: prevention of whooping cough in infants

Vera Amaral, Marisa Loio, Nelson Ferreira Ribeiro


Background: A reemergence of whooping cough has currently been observed in countries with high vaccination coverage, including Portugal. Infants under three months of age are the most vulnerable group. New vaccination strategies have been proposed, including vaccination in the third trimester of pregnancy. However, its implementation is still limited, due to concerns about its efficacy and safety.

Objective: To review the evidence on the efficacy and safety of tetanus, diphtheria, acellular pertussis (Tdap) vaccine administered during pregnancy in preventing whooping cough in infants.

Methods: A research was conducted on Medline, evidence based medicine databases, the Portuguese Society of Pediatrics and Portuguese Directorate-General of Health sites. Clinical guidelines (CG), systematic reviews and original studies (OS) published between 01/07/2009 and 15/07/2014 in Portuguese, Spanish and English languages were selected, using the MeSH terms pertussis vaccine and pregnancy.

Results: The majority of CG recommends vaccination of all pregnant women in the third trimester. The OS show that Tdap administered during pregnancy is effective by increasing anti-pertussis antibodies concentrations in mothers and infants and reducing the disease cases and hospitalizations in infants. The vaccine does not appear to be associated with increased maternal or fetal adverse effects.

Conclusion: Tdap vaccination during the third trimester of pregnancy appears to be safe and effective in preventing
whooping cough in infants.


pregnancy; whooping cough; pertussis vaccine

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