Serologic screening for anti-rubella immunoglobulin G antibodies in Romanian pregnant women: an unexpected rate of seronegativity.

OBJECTIVES

This study assessed the risk of rubella infection among pregnant women in Romania.

METHODS

Serologic testing was conducted between 2022 and 2023 in 1,279 women to determine the presence of specific anti-rubella immunoglobulin (Ig)G antibodies using the Elecsys rubella IgG assay designed for Cobas e 411 analyzers.

RESULTS

The overall seroprevalence of IgG antibodies was 87.02%, indicating protective immunity developed after past infection or vaccination. However, in 12.98% of the pregnant women, anti-rubella antibodies were not detected. Pregnant women aged 12-19 years, who should have been vaccinated with the measles-mumps-rubella vaccine according to the national vaccination program, had the highest rate of seronegativity (21.15%).

CONCLUSIONS

This study provides insights into the epidemiology and susceptibility to rubella infection among pregnant women in Romania. Our results indicate that the rubella seronegativity rate was significant. This finding may be explained by potential vaccine hesitancy, challenges within the vaccination program and "failure to vaccinate" in this population group. Public health authorities should expand awareness of the risks associated with rubella infection and increase education on vaccine efficacy, especially among women of reproductive age, to further improve vaccination coverage and prevent congenital rubella syndrome.