AS an obstetrics and gynaecology (O&G) specialist, I am always having conversations with patients who are pregnant mothers. My patients are fairly open with sharing their physical, mental and emotional journeys from the moment they discover that they’re pregnant. They may all come from different cultural and religious backgrounds, but the one thing pregnant moms have in common would be their innate desire to do everything in their power to keep their unborn baby safe from harm.
The first thing I would recommend to pregnant moms – especially those expecting their first child – is that they talk to their doctors, right from the start. Keep talking to your doctor throughout your nine months! From healthcare providers, pregnant moms can learn more about important matters such as maternal immunisation (MI) that will provide their unborn infants protection from life-threatening infectious diseases such as pertussis (whooping cough).
Pertussis is a highly contagious disease that can be particularly harmful for newborn infants. In my time of practice I have had a patient whose 3-week-old baby became infected with pertussis. The mother was in her early 40s at that time with a challenged obstetric history. This incident was traumatic for her. It was a precious pregnancy – her first child after six failed pregnancies previously.
All was well at the baby’s birth and the baby was brought home like normal. Three weeks later, my patient had a friend come to visit with two children, who spent some time playing with the newborn baby. Her friend neglected to mention that both her children had just recently been discharged from the hospital.
About four days later, my patient’s baby developed a bad cold, became listless, started coughing and was then turning blue. The baby was rushed to hospital emergency where blood tests and chest x-rays revealed that the baby had pertussis. The baby was treated with antibiotics and oxygen therapy. Additionally, the baby was put on a ventilator for a few days.
My patient is glad and grateful that her child recovered well and is now a happy, healthy 4-year-old girl… It was such a touch-and-go situation! At the same time, she told me how distressed and upset she had been that her friend did not think about the sensitivities of the situation that led to her baby’s whooping cough infection, even if it were just a brief encounter between the children.
My patient, who had not taken the Tdap (tetanus-diphtheria-pertussis) vaccine whilst pregnant, also shared with me in retrospect that she wished she had vaccinated with the Tdap vaccine during her pregnancy as it likely would have prevented the pertussis trauma her baby had to endure at a vulnerable 3 weeks of age.
Without a doubt, the Covid-19 pandemic has disrupted routine children’s vaccinations worldwide, as shown by data published recently in July by the World Health Organisation (WHO) and Unicef. Approximately 23 million children missed out on basic childhood vaccines in 2020. This marks the highest number in over a decade and 3.7 million more than in 2019, leaving millions of children at risk of vaccine preventable diseases (VPDs) such as tetanus, diphtheria and pertussis.
Given this scenario, it is now more important than ever for pregnant moms to be alert and to not neglect their vaccinations during pregnancy. The Tdap vaccine will safely provide immunity for pregnant moms and their unborn infants against tetanus, diphtheria and pertussis.
The Malaysian Society of Infectious Diseases and Chemotherapy (MSIDC) recommends that all moms receive a dose of the Tdap vaccine between 27 and 36 weeks of each pregnancy, as it reduces by over 90% the unborn baby’s risk of getting infected by pertussis and reduces by 95% death due to pertussis in babies 3 months and below.
The Centers for Disease Control and Protection (CDC) reinforces that the Tdap vaccine is recommended during every pregnancy, regardless of how long it has been since you previously received this vaccine. – The Vibes, October 4, 2021
Dr Kiren Sidhu is a consultant obstetrician and gynaecologist at Pantai Hospital Kuala Lumpur
