| Rubella infection within the frst trimester of pregnancy may lead to adverse pregnancy outcomes. The present study was
conducted to evaluate the immunity against rubella among the pregnant Iranian women. The steps of meta-analyses were
conducted based on the MOOSE protocol and results were reported according to the PRISMA guideline. To review the associated English and Persian literature, a comprehensive search was conducted among the international databases such as
Scopus, PubMed/Medline, Science Direct, Embase, Cochrane library, Web of Science and Google Scholar search engine
as well as Iranian databases, until April 1, 2018 using the following medical subject headings (MeSH) keywords: ‘Pregnant’, ‘Gestational’, ‘Prenatal care’, ‘Complications of pregnancy’, ‘Pregnancy’, ‘Rubella infection’, ‘Prevalence, ‘Epidemiology’, ‘Immunity’, ‘Immunization’, ‘Antibody’, ‘Immunogenicity’ and ‘Iran’. Cochran’s Q test and I2 index were
used to investigate heterogeneity in the studies. Random effects model was used to estimate the rate of rubella immunity.
The obtained data were analyzed using Comprehensive Meta-Analysis Ver.2. Fifteen studies constituting 7,601 pregnant
Iranian women met the inclusion criteria. The overall pooled rubella immunity rate was 90.1% [95% confdence interval
(CI): 86.1-93.1]. Rubella immunity rates were respectively 88.6% (95% CI: 80.6-93.6) and 91.5% (95% CI: 88.1-93.9)
before and after national vaccine program. Rubella immunity rates were 91.4% (95% CI: 87.8-94.0) and 87.2% (95% CI:
74.3-94.1) based on the enzyme-linked immunosorbent assay (ELISA) and haemagglutination-inhibition (HAI) methods,
respectively. There was no signifcant association between rubella immunity and vaccination program (P=0.398), diagnostic methods (P=0.355), geographic regions (P=0.286), quality of the studies (P=0.751), occupation (P=0.639), residence
(P=0.801), and year of the studies (P=0.164), but it was signifcantly associated with age (P<0.001).
Despite high rubella immunity among the pregnant Iranian women, anti-rubella antibody screening is recommended
for all women of childbearing age. |