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Passive and active immunity in infants born to mothers with SARS-CoV-2 infection during pregnancy: prospective cohort study.
Song, Dongli; Prahl, Mary; Gaw, Stephanie L; Narasimhan, Sudha Rani; Rai, Daljeet S; Huang, Angela; Flores, Claudia V; Lin, Christine Y; Jigmeddagva, Unurzul; Wu, Alan; Warrier, Lakshmi; Levan, Justine; Nguyen, Catherine B T; Callaway, Perri; Farrington, Lila; Acevedo, Gonzalo R; Gonzalez, Veronica J; Vaaben, Anna; Nguyen, Phuong; Atmosfera, Elda; Marleau, Constance; Anderson, Christina; Misra, Sonya; Stemmle, Monica; Cortes, Maria; McAuley, Jennifer; Metz, Nicole; Patel, Rupalee; Nudelman, Matthew; Abraham, Susan; Byrne, James; Jegatheesan, Priya.
  • Song D; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Prahl M; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
  • Gaw SL; Department of Pediatrics, Division of Pediatric Infectious Diseases and Global Health, University of California San Francisco, San Francisco, California, USA.
  • Narasimhan SR; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
  • Rai DS; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Huang A; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
  • Flores CV; Department of Family Medicine, Stanford University School of Medicine, Stanford, California, USA.
  • Lin CY; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Jigmeddagva U; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Wu A; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
  • Warrier L; Department of Pediatrics, Division of Pediatric Infectious Diseases and Global Health, University of California San Francisco, San Francisco, California, USA.
  • Levan J; Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.
  • Nguyen CBT; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Callaway P; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Farrington L; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Acevedo GR; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Gonzalez VJ; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Vaaben A; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Nguyen P; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, USA.
  • Atmosfera E; Department of Medicine, University of California San Francisco, San Francisco, California, USA.
  • Marleau C; Department of Pathology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Anderson C; Department of Pathology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Misra S; Department of Pathology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Stemmle M; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Cortes M; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
  • McAuley J; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Metz N; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
  • Patel R; Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
  • Nudelman M; Department of Pediatrics, Division of Pediatric Hospital Medicine, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Abraham S; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Byrne J; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
  • Jegatheesan P; Department of Pediatrics, Division of Neonatology, Santa Clara Valley Medical Center, San Jose, California, USA.
BMJ Open ; 11(7): e053036, 2021 07 07.
Article in English | MEDLINE | ID: covidwho-1301650
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT

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.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-053036

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-053036