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

被引：55

作者：

Song, Dongli ^{[1
]}

Prahl, Mary ^{[2
,3
]}

Gaw, Stephanie L. ^{[4
]}

Narasimhan, Sudha Rani ^{[1
,2
]}

Rai, Daljeet S. ^{[5
]}

Huang, Angela ^{[1
]}

Flores, Claudia, V ^{[1
]}

Lin, Christine Y. ^{[4
]}

Jigmeddagva, Unurzul ^{[3
]}

Wu, Alan ^{[6
]}

Warrier, Lakshmi ^{[7
]}

Levan, Justine ^{[7
]}

Nguyen, Catherine B. T. ^{[7
]}

Callaway, Perri ^{[7
]}

Farrington, Lila ^{[7
]}

Acevedo, Gonzalo R. ^{[7
]}

Gonzalez, Veronica J. ^{[4
]}

Vaaben, Anna ^{[7
]}

Nguyen, Phuong ^{[8
]}

Atmosfera, Elda ^{[8
]}

Marleau, Constance ^{[8
]}

Anderson, Christina ^{[1
,2
]}

Misra, Sonya ^{[1
,2
]}

Stemmle, Monica ^{[9
]}

Cortes, Maria ^{[1
,2
]}

McAuley, Jennifer ^{[1
,2
]}

Metz, Nicole ^{[1
,2
]}

Patel, Rupalee ^{[1
,2
]}

Nudelman, Matthew ^{[10
]}

Abraham, Susan ^{[9
]}

Byrne, James ^{[11
,12
]}

Jegatheesan, Priya ^{[1
,2
]}

机构：

[1] Santa Clara Valley Med Ctr, Div Neonatol, Dept Pediat, San Jose, CA 95128 USA

[2] Stanford Univ, Sch Med, Dept Pediat, Stanford, CA 94305 USA

[3] Univ Calif San Francisco, Dept Pediat, Div Pediat Infect Dis & Global Hlth, San Francisco, CA USA

[4] Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, Div Maternal Fetal Med, San Francisco, CA USA

[5] Stanford Univ, Sch Med, Dept Family Med, Stanford, CA 94305 USA

[6] Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA

[7] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[8] Santa Clara Valley Med Ctr, Dept Pathol, San Jose, CA 95128 USA

[9] Santa Clara Valley Med Ctr, Div Pediat Hosp Med, Dept Pediat, San Jose, CA 95128 USA

[10] Marshall Univ, Dept Pediat, Huntington, WV USA

[11] Santa Clara Valley Med Ctr, Div Maternal Fetal Med, Dept Obstet & Gynecol, San Jose, CA 95128 USA

[12] Stanford Univ, Sch Med, Dept Obstet & Gynecol, Stanford, CA USA

来源：

BMJ OPEN | 2021年 / 11卷 / 07期

基金：

美国国家卫生研究院;

关键词：

COVID-19; immunology; neonatology; paediatric infectious disease & immunisation; OUTCOMES;

D O I：

10.1136/bmjopen-2021-053036

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To investigate maternal immunoglobulins' (IgM, IgG) response to SARS-CoV-2 infection during pregnancy and IgG transplacental transfer, to characterise neonatal antibody response to SARS-CoV-2 infection, and to longitudinally follow actively and passively acquired antibodies in infants. Design A prospective observational study. Setting Public healthcare system in Santa Clara County (California, USA). Participants Women with symptomatic or asymptomatic SARS-CoV-2 infection during pregnancy and their infants were enrolled between 15 April 2020 and 31 March 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 8 with severe-critical symptoms. The seropositivity rates of the mothers at delivery was 65% (95% CI 0.56% to 0.73%) and the cord blood was 58% (95% CI 0.49% to 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 with <60 days (1.2 vs 0.6, p<0.0001). Infant IgG seroreversion rates over follow-up periods of 1-4, 5-12, and 13-28 weeks were 8% (4 of 48), 12% (3 of 25), and 38% (5 of 13), respectively. The IgG seropositivity in the infants was positively related to IgG levels in the cord blood and persisted up to 6 months of age. Two newborns showed seroconversion at 2 weeks of age with high levels of IgM and IgG, including one premature infant with confirmed intrapartum infection. Conclusions Maternal SARS-CoV-2 IgG is efficiently transferred across the placenta when infections occur more than 2 months before delivery. Maternally derived passive immunity may persist in infants up to 6 months of life. Neonates are capable of mounting a strong antibody response to perinatal SARS-CoV-2 infection.

引用

页数：10

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