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

ObjectiveTo 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.DesignA prospective observational study.SettingPublic healthcare system in Santa Clara County (California, USA).ParticipantsWomen with symptomatic or asymptomatic SARS-CoV-2 infection during pregnancy and their infants were enrolled between 15 April 2020 and 31 March 2021.OutcomesSARS-CoV-2 serology analyses in the cord and maternal blood at delivery and longitudinally in infant blood between birth and 28 weeks of life.ResultsOf 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.ConclusionsMaternal 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.

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

10.1101/2021.05.01.21255871 ◽

2021 ◽

Author(s):

Dongli Song ◽

Mary Prahl ◽

Stephanie Gaw ◽

Sudha Rani Narasimhan ◽

Daljeet S Rai ◽

...

Keyword(s):

Antibody Response ◽

Cord Blood ◽

Prospective Observational Study ◽

Maternal Blood ◽

Public Healthcare ◽

Transplacental Transfer ◽

Santa Clara County ◽

Study Setting ◽

Negative Conversion

OBJECTIVE To investigate maternal immunoglobulin (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.

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Cellular and antibody response to respiratory syncytial (rs) virus in human colostrum, maternal blood, and cord blood

Journal of Medical Virology ◽

10.1002/jmv.1890080105 ◽

1981 ◽

Vol 8 (1) ◽

pp. 55-66 ◽

Cited By ~ 17

Author(s):

R. Scott ◽

M. Scott ◽

G. L. Toms

Keyword(s):

Antibody Response ◽

Cord Blood ◽

Maternal Blood ◽

Human Colostrum

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Immunological products and vaccines

Revision Notes for MCEM Part A ◽

10.1093/med/9780199583836.003.0046 ◽

2011 ◽

pp. 415-422

Author(s):

Dr Mark Harrison

Keyword(s):

Antibody Response ◽

Aluminium Hydroxide ◽

Passive Immunity ◽

Immune Mechanism ◽

Active Immunity ◽

Primary Series ◽

Inactivated Vaccines ◽

Adequate Antibody Response

9.1 Active immunity, 416 9.2 Passive immunity, 418 9.3 Specific vaccines and preparations, 418 9.4 Immunoglobulins (Ig), 421 Vaccines stimulate production of antibodies and other components of the immune mechanism. • Inactivated ▪ Heat/chemically inactivated virulent microorganism (virus or bacteria). ▪ May require a primary series of injections of vaccine to produce an adequate antibody response, and in most cases booster (reinforcing) injections are required; the duration of immunity varies from months to many years. Some inactivated vaccines are adsorbed onto an adjuvant (such as aluminium hydroxide) to enhance the antibody response....

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2160 Does maternal schistosomiasis affect the humoral and cellular vaccine responses of infants?

Journal of Clinical and Translational Science ◽

10.1017/cts.2018.67 ◽

2018 ◽

Vol 2 (S1) ◽

pp. 10-10

Author(s):

Deborah Bloch ◽

Taryn McLaughlin ◽

Cheryl Day ◽

W. Evan Secor ◽

Govert van Dam ◽

...

Keyword(s):

Cord Blood ◽

Vaccine Development ◽

Maternal Blood ◽

Bcg Vaccine ◽

Public Health Policies ◽

Transplacental Transfer ◽

Vaccine Responses ◽

Th1 Cytokine ◽

Study Population ◽

Egg Antigen

OBJECTIVES/SPECIFIC AIMS: The aims of this study are 2-fold: (1) to determine if maternal schistosomiasis affects maternal immunity to tetanus and/or transplacental transfer of antitetanus toxoid (TT) immunoglobulin G (IgG) from mother to infant and (2) determine the influence of maternal schistosomiasis on infant BCG vaccine immunogenicity. METHODS/STUDY POPULATION: The study will utilize blood samples from a historic cohort of 100 mother-infant pairs from Kisumu, Kenya, a schistosomiasis-endemic area. For the first aim, we will evaluate maternal schistosomal circulating anodic antigen, which has improved sensitivity and specificity to detect active schistosomiasis from serum, and antisoluble egg antigen IgG positivity compared with quantitative maternal anti-TT IgG at delivery and anti-TT IgG cord blood to maternal blood ratio (cord:maternal ratio). For the second aim, we will evaluate association between maternal schistosomiasis as detected by circulating anodic antigen and antisoluble egg antigen IgG at delivery and infant BCG-specific Th1-cytokine positive CD4+ cells at 10 weeks following BCG vaccination at birth. RESULTS/ANTICIPATED RESULTS: We hypothesize that active maternal schistosomiasis will be associated with decreased maternal anti-TT IgG and reduced efficiency of transplacental transfer, as measured by infant cord blood to maternal blood ratio of anti-TT IgG. We also expect that maternal schistosomiasis will be associated with decreased infant immunogenicity to BCG vaccine. DISCUSSION/SIGNIFICANCE OF IMPACT: This is a formative study on infant vaccine immunity using laboratory methodology not previously applied. Understanding infant immunity in the setting of maternal schistosomiasis will inform vaccination strategies and tailor vaccine development in schistosome-endemic areas such as Kenya, where neither TB nor neonatal tetanus have been eradicated. Additionally, our results will inform public health policies to consider integration of antischistosomal agents in antenatal care.

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Immunological assessment of SARS-CoV-2 Infection in Pregnancy From Diagnosis to Delivery: A multicentre prospective observational study

10.22541/au.160554794.41545816/v1 ◽

2020 ◽

Author(s):

Kate Glennon ◽

Jennifer Donnelly ◽

Susan Knowles ◽

Fionnuala McAuliffe ◽

Alma O Reilly ◽

...

Keyword(s):

Antibody Response ◽

Prospective Observational Study ◽

Passive Immunity ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Low Prevalence ◽

Fetal Response ◽

Study Setting ◽

Multicentre Prospective Study ◽

In Pregnancy

Objective We profile the maternal and fetal response to SARS-CoV-2 infection in symptomatic and asymptomatic pregnant women and make an assessment of passive immunity to the neonate, Design Multicentre prospective study. Setting Dublin, Ireland Methods RT-PCR for viral RNA via a nasopharyngeal swab was performed using the Cobas SARS-CoV-2 6800 platform. Maternal, and fetal serological antibody response, via umbilical cord bloods, was measured using both the Elecsys® immunoassay, Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Main outcome Measure Prevalence of RT PCR positive SARS-CoV-2. Assessment of IgM and IgG anti-SARS-CoV-2 serology antibodies. Results Ten of twenty three symptomatic women had SARS-CoV-2 RNA in a nasopharyngeal swab. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3–5·5%). Nine women had repeat testing between post baseline. Four (4/9, 44%) remained IgM positive, one IgG positive. IgG anti SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. Conclusion Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV-2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.

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Increased Alkaline Phosphatase in Cord Blood of Obese Diabetic Mothers Is Associated to Polyunstaurated Fatty Acid Levels

Annals of Nutrition and Metabolism ◽

10.1159/000504404 ◽

2019 ◽

Vol 75 (3) ◽

pp. 153-162

Author(s):

María T. Prieto-Sánchez ◽

José E. Blanco-Carnero ◽

María Ruiz-Palacios ◽

Ana Pagán ◽

Antonio J. Ruiz-Alcaraz ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Fatty Acid ◽

Cord Blood ◽

Prospective Observational Study ◽

Maternal Blood ◽

Transport Proteins ◽

Third Trimester ◽

Fetal Ultrasound ◽

Diabetic Mothers ◽

Lower Expression

Introduction: Recent studies indicate that alkaline phosphatase (ALP) may affect expression and activity of fatty acid (FA) transport proteins in placenta and other tissues. Objective: To evaluate if disturbed FA profile in offspring of gestational diabetes mellitus (GDM) with different maternal pregestational weight could be related to maternal or neonatal ALP. Methods: Prospective observational study of pregnant women recruited in the third trimester (25 controls, 23 lean-GDM, 20 obese-GDM). Fetal ultrasound was performed. At delivery, FAs were analyzed in placenta, maternal, and venous cord blood. Western blotting analysis of lipid carriers was performed in placenta. Results: Newborns from obese-GDM tended to higher birthweight (p = 0.059) than those from both lean-GDM and controls. ALP in maternal blood tended to be lower in GDM (p = 0.170) while increased significantly in cord blood of obese-GDM with respect to controls (p = 0.039). Saturated FA percentages in cord blood were significantly higher (p < 0.000), while polyunsaturated FA (PUFA) percentages were lower (p = 0.003) in both GDM, which could be due to a lower expression of major family domain 2a receptor (MFSD2a) in the placenta. Plasma ALP in the offspring of obese-GDM was inversely associated to cord essential PUFAs (β = –6.18, p = 0.005) and to placental MFSD2a (β = –38.46, p = 0.014). Conclusions: Cord PUFA and placental MFSD2a are decreased in both lean and obese-GDM pregnancies. Higher ALP in cord blood of obese-GDM could play a role in the FA levels in these pregnancies

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