{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:04:33Z","timestamp":1790229873820,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rubella elimination has substantially reduced virus circulation in China, but the changing pattern of immunity among women entering reproductive age remains unclear. We assessed the contemporary rubella immunity profile among pregnant women in Jiangsu Province.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional serological study of 1,196 pregnant women in Jiangsu Province. Rubella-specific IgG antibodies were quantitatively measured. Seropositivity and antibody concentrations were compared across maternal age and birth cohorts. Restricted cubic spline (RCS) regression was used to assess nonlinear associations between age and immunity, and multivariable regression identified factors associated with seronegativity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall rubella IgG seropositivity was 61.45%, with a geometric mean concentration of 24.21 IU\/mL. Seropositivity increased from 37.77% among women aged \u226424 years to approximately 75% among women aged \u226530 years. Antibody concentrations showed a similar age-related gradient, with a nonlinear association between maternal age and rubella immunity. Younger birth cohorts consistently exhibited lower seropositivity and antibody concentrations, indicating a concentrated immunity gap among women entering reproductive age. Maternal age remained independently associated with rubella immunity, whereas gestational age was not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite sustained high RCV coverage and declining rubella transmission in China, substantial heterogeneity in maternal rubella immunity persists. Younger women and more recent birth cohorts may represent important susceptibility groups. Integrating maternal immunity surveillance with sustained childhood vaccination and preconception prevention strategies may help maintain rubella elimination and prevent congenital rubella syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1971227","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:44:56Z","timestamp":1790228696000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal rubella immunity gaps in the vaccine era: a seroepidemiological study of pregnant women in Jiangsu, China"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiang","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jiangsu Province (Suqian) Hospital","place":["Suqian, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02691-X","article-title":"Rubella","volume":"399","author":"Ak","year":"2022","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7023a1","article-title":"Progress toward rubella elimination - World Health Organization European Region, 2005-2019","volume":"70","author":"O'Connor","year":"2021","journal-title":"MMWR Morbidity Mortality Weekly Rep"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7225a2","article-title":"Progress toward rubella elimination - World Health Organization South-East Asia Region, 2013-2021","volume":"72","author":"Khanal","year":"2023","journal-title":"MMWR Morbidity Mortality Weekly Rep"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2024.262","article-title":"Impact of immunization strategies on rubella incidence during progress toward rubella control and elimination - China, 2004\u20132023","volume":"6","author":"Liu","year":"2024","journal-title":"China CDC Weekly"},{"key":"B5","doi-asserted-by":"publisher","first-page":"17982","DOI":"10.1038\/s41598-017-18281-2","article-title":"Progress towards rubella elimination after implementation of rubella immunization for over 20 years in Shandong province, China","volume":"7","author":"Wang","year":"2017","journal-title":"Sci Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1086\/605410","article-title":"Persistence of rubella antibodies after 2 doses of measles-mumps-rubella vaccine","volume":"200","author":"LeBaron","year":"2009","journal-title":"J Infect Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410x(95)00064-8","article-title":"Persistence of anti-mumps virus antibodies after a two-dose MMR vaccination. 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