Department of Neonatology, Medical College, Bharati Vidyapeeth (Deemed To Be University), Pune, Maharashtra, India.
Department of Pediatrics, Medical College, Bharati Vidyapeeth (Deemed To Be University), Pune, Maharashtra, India.
Infection. 2022 Feb;50(1):131-137. doi: 10.1007/s15010-021-01650-5. Epub 2021 Jul 7.
COVID-19 pandemic remains a serious public health threat worldwide. In view of the limited data on the risk of perinatal transmission of SARS-CoV-2 and transfer of maternal anti-SARS-CoV-2 antibodies, the present study was undertaken.
A prospective study including 57 pregnant women with a positive SARS-CoV-2 RNA test (SARS-CoV-2-RNA+) and 59 neonates born to them was conducted at Pune, India. 39 viral RNA negative (SARS-CoV-2-RNA-negative) pregnant women and their 39 neonates were included as controls. Neonatal nasal swab/cord blood samples were subjected to SARS-CoV-2 RNA detection by RT-PCR for investigation of perinatal transmission. Transfer of maternal antibodies was studied using ELISA and PRNT.
10/57 SARS-CoV-2-RNA+ mothers were symptomatic. The duration between COVID-19 diagnosis and delivery was ≤ 7 days for 82.4%. Perinatal transmission as evidenced by viral RNA in the neonatal nasal swab/cord blood (CB) was 3.6%. IgG-anti-SARS-CoV-2 positivity was 21.6%. Of the 39 neonates born to SARS-CoV-2-RNA-negative mothers, 20 (51%) and none, respectively, were positive for IgG-anti-SARS-CoV-2 and viral RNA. Preterm deliveries were higher in SARS-CoV-2-RNA+ (18.6%) than SARS-CoV-2 RNA-negative (0/39) mothers (p < 0.005). Respiratory distress at birth (< 4 h) was higher among neonates of SARS-CoV-2-RNA+ (20/59, 33.9%) than SARS-CoV-2-RNA-negative mothers (3/39, 7.7%; p < 0.001). ~ 75% IgG-positives exhibited neutralization potential with mean PRNT titers of 42.4 ± 24 (SARS-CoV-2-RNA+) and 72.3 ± 46.7 (SARS-CoV-2 RNA-negative); higher in the latter (p < 0.05).
The rate of perinatal transmission was low. Transfer of maternal antibodies was lower among SARS-CoV-2-RNA+ mothers than SARS-CoV-2-RNA-negative mothers with subclinical infection during pregnancy. Presence of neutralizing antibodies in majority of IgG-positives suggests protection from SARS-CoV-2 in early life.
COVID-19 大流行仍然是全球严重的公共卫生威胁。鉴于 SARS-CoV-2 围产期传播和母体抗 SARS-CoV-2 抗体转移的有限数据，本研究进行了。
在印度浦那进行了一项包括 57 名 SARS-CoV-2 RNA 检测阳性（SARS-CoV-2-RNA+）孕妇及其 59 名新生儿的前瞻性研究。选择 39 名病毒 RNA 阴性（SARS-CoV-2-RNA-阴性）孕妇及其 39 名新生儿作为对照。采用 RT-PCR 检测新生儿鼻拭子/脐带血中的 SARS-CoV-2 RNA，以检测围产期传播。采用 ELISA 和 PRNT 检测母体抗体转移。
10/57 SARS-CoV-2-RNA+孕妇有症状。COVID-19 诊断与分娩的时间间隔≤7 天者占 82.4%。新生儿鼻拭子/脐带血中病毒 RNA 证实存在围产期传播 3.6%。IgG-抗 SARS-CoV-2 阳性率为 21.6%。39 名 SARS-CoV-2-RNA-阴性母亲所生的新生儿中，IgG-抗 SARS-CoV-2 和病毒 RNA 阳性者分别为 20 例（51%）和 0 例。SARS-CoV-2-RNA+孕妇（18.6%）早产率高于 SARS-CoV-2 RNA-阴性孕妇（0/39）（p<0.005）。SARS-CoV-2-RNA+新生儿（59 例）出生后 4 小时内呼吸窘迫发生率高于 SARS-CoV-2 RNA-阴性母亲（39 例）（33.9%对 7.7%；p<0.001）。~75% IgG 阳性者具有中和潜力，平均 PRNT 滴度分别为 SARS-CoV-2-RNA+（42.4±24）和 SARS-CoV-2 RNA-阴性（72.3±46.7）；后者更高（p<0.05）。
围产期传播率较低。SARS-CoV-2 围产期传播率低于 SARS-CoV-2 RNA 阴性孕妇，提示妊娠期亚临床感染时母体抗体转移减少。大多数 IgG 阳性者存在中和抗体提示在生命早期对 SARS-CoV-2 具有保护作用。
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