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. 2023 Jan 11;227(2):236-245.
doi: 10.1093/infdis/jiac366.

Longitudinal Evaluation of Antibody Persistence in Mother-Infant Dyads After Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy

Mary C Cambou  1 , Christine M Liu  1 , Thalia Mok  2 , Viviana Fajardo-Martinez  3 , Sophia G Paiola  3 , Francisco J Ibarrondo  1 , Tara Kerin  3 , Trevon Fuller  3   4 , Nicole H Tobin  3 , Gustavo Garcia  5 , Debika Bhattacharya  1 , Grace M Aldrovandi  3 , Vaithilingaraja Arumugaswami  5 , Suan-Sin Foo  6 , Jae U Jung  6 , Zilton Vasconcelos  4 , Patricia Brasil  4 , Michelle Brendolin  7 , Otto O Yang  1 , Rashmi Rao  2 , Karin Nielsen-Saines  3
Affiliations

Longitudinal Evaluation of Antibody Persistence in Mother-Infant Dyads After Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Pregnancy

Mary C Cambou et al. J Infect Dis. .

Abstract

Background: There are limited data on how coronavirus disease 2019 (COVID-19) severity, timing of infection, and subsequent vaccination impact transplacental transfer and persistence of maternal and infant antibodies.

Methods: In a longitudinal cohort of pregnant women with polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, maternal/infant sera were collected at enrollment, delivery/birth, and 6 months. Anti-SARS-CoV-2 spike immunoglobulin (Ig)G, IgM, and IgA were measured by enzyme-linked immunosorbent assay.

Results: Two-hundred fifty-six pregnant women and 135 infants were enrolled; 148 maternal and 122 neonatal specimens were collected at delivery/birth; 45 maternal and 48 infant specimens were collected at 6 months. Sixty-eight percent of women produced all anti-SARS-CoV-2 isotypes at delivery (IgG, IgM, IgA); 96% had at least 1 isotype. Symptomatic disease and vaccination before delivery were associated with higher maternal IgG at labor and delivery. Detectable IgG in infants dropped from 78% at birth to 52% at 6 months. In the multivariate analysis evaluating factors associated with detectable IgG in infants at delivery, significant predictors were 3rd trimester infection (odds ratio [OR] = 4.0), mild/moderate disease (OR = 4.8), severe/critical disease (OR = 6.3), and maternal vaccination before delivery (OR = 18.8). No factors were significant in the multivariate analysis at 6 months postpartum.

Conclusions: Vaccination in pregnancy post-COVID-19 recovery is a strategy for boosting antibodies in mother-infant dyads.

Keywords: COVID-19 in pregnancy; SARS-CoV-2 in pregnancy; transplacental transfer.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

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