Passive and active immunity in infants born to mothers with SARS-CoV-2 infection during pregnancy: Prospective cohort study.

Autor:	Song D; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Prahl M; Department of Pediatrics, Division of Pediatric Infectious Diseases and Global Health, University of California, San Francisco, CA, USA., Gaw SL; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA., Narasimhan S; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Rai D; Department of Family Medicine, Stanford University School of Medicine, Stanford, CA, USA., Huang A; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., Flores C; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., Lin CY; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA., Jigmeddagva U; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA., Wu AHB; Department of Laboratory Medicine, University of California, San Francisco, CA, USA., Warrier L; Department of Medicine, University of California San Francisco, CA, USA., Levan J; Department of Medicine, University of California San Francisco, CA, USA., Nguyen CBT; Department of Medicine, University of California San Francisco, CA, USA., Callaway P; Department of Medicine, University of California San Francisco, CA, USA., Farrington L; Department of Medicine, University of California San Francisco, CA, USA., Acevedo GR; Department of Medicine, University of California San Francisco, CA, USA., Gonzalez VJ; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA., Vaaben A; Department of Medicine, University of California San Francisco, CA, USA., Nguyen P; Department of Pathology, Santa Clara Valley Medical Center, San Jose, CA, USA., Atmosfera E; Department of Pathology, Santa Clara Valley Medical Center, San Jose, CA, USA., Marleau C; Department of Pathology, Santa Clara Valley Medical Center, San Jose, CA, USA., Anderson C; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Misra S; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Stemmle M; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Cortes M; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., McAuley J; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., Metz N; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., Patel R; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA., Nudelman M; Department of Pediatrics, Marshall University, Huntington, WV, USA., Abraham S; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA., Byrne J; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Santa Clara Valley, CA, USA.; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA., Jegatheesan P; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, CA, USA.; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2021 May 03. Date of Electronic Publication: 2021 May 03.
DOI:	10.1101/2021.05.01.21255871
Abstrakt:	Objective: To investigate maternal immunoglobulins' (IgM, IgG) response to SARS-CoV-2 infection during pregnancy and IgG transplacental transfer, to characterize neonatal antibody response to SARS-CoV-2 infection, and to longitudinally follow actively- and passively-acquired SARS-CoV-2 antibodies in infants. Design: A prospective observational study. Setting: A public healthcare system in Santa Clara County (CA, USA). Participants: Women with SARS-CoV-2 infection during pregnancy and their infants were enrolled between April 15, 2020 and March 31, 2021. Outcomes: SARS-CoV-2 serology analyses in the cord and maternal blood at delivery and longitudinally in infant blood between birth and 28 weeks of life. Results: Of 145 mothers who tested positive for SARS-CoV-2 during pregnancy, 86 had symptomatic infections: 78 with mild-moderate symptoms, and eight with severe-critical symptoms. Of the 147 newborns, two infants showed seroconversion at two weeks of age with high levels of IgM and IgG, including one premature infant with confirmed intrapartum infection. The seropositivity rates of the mothers at delivery was 65% (95% CI 0.56-0.73) and the cord blood was 58% (95% CI 0.49-0.66). IgG levels significantly correlated between the maternal and cord blood (Rs= 0.93, p< 0.0001). IgG transplacental transfer ratio was significantly higher when the first maternal positive PCR was 60-180 days before delivery compared to <60 days (1.2 vs. 0.6, p=<0.0001). Infant IgG negative conversion rate over follow-up periods of 1-4, 5-12, and 13-28 weeks were 8% (4/48), 12% (3/25), and 38% (5/13), respectively. The IgG seropositivity in the infants was positively related to IgG levels in the cord blood and persisted up to six months of age. Conclusions: Maternal SARS-CoV-2 IgG is efficiently transferred across the placenta when infections occur more than two months before delivery. Maternally-derived passive immunity may protect infants up to six months of life. Neonates mount a strong antibody response to perinatal SARS-CoV-2 infection. Competing Interests: Competing interests’ statement None declared.
Databáze:	MEDLINE
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