Department of Obstetrics and Gynecology and the Clinical Serology and Virology Laboratory, Carmel Medical Center, the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, and Community Medicine and Epidemiology, the Lady Davis Carmel Medical Center, Haifa, Israel.
Obstet Gynecol. 2022 Aug 1;140(2):187-193. doi: 10.1097/AOG.0000000000004867. Epub 2022 May 27.
To evaluate maternal and neonatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibody levels at birth after a third (booster) dose of the Pfizer-BioNTech messenger RNA (Pfizer) coronavirus disease 2019 (COVID-19) vaccine during the second trimester of pregnancy, and compare them with those in women who received two vaccine doses during the second trimester.
We conducted a prospective cohort study of women admitted to the delivery ward at a single center who received the third Pfizer COVID-19 vaccine dose (booster group) at 17-30 weeks of pregnancy and who did not have previous SARS-CoV-2 infection. Maternal and neonatal antibody levels were measured on admission for delivery and in the umbilical cord blood after birth. Antibody levels for the booster group were compared with those in a historical control group of pregnant women who received their second vaccine dose (two-dose group) within the same gestational age window.
Between October 2021 and February 2022, antibody levels were measured in 121 women and 109 neonates at a mean±SD of 15.3±3.9 weeks after booster vaccination. Neonatal titers measured two times higher than maternal titers, with inverse correlation between maternal and neonatal titers at birth and time interval from third vaccination. The two-dose group included 121 women and 107 neonates, with antibody levels measured at a mean±SD of 14.6±2.6 weeks after the second dose. Median [interquartile range] maternal antibody titers were higher in the booster group (4,485 [2,569-9,702] AU/mL) compared with the two-dose group (1,122 [735-1,872] AU/mL) (P<.001). Furthermore, neonatal antibody titers were higher in the booster group (8,773 [5,143-18,830] AU/mL) compared with the two-dose group (3,280 [2,087-5,754] AU/mL) (P<.001).
Maternal and neonatal SARS-CoV-2 IgG antibody titers after second-trimester maternal Pfizer COVID-19 vaccination were significantly higher after the booster dose compared with the two-dose vaccination series. Although there is uncertainty as to whether antibody levels correlate with protection, these data support the importance of booster vaccination during pregnancy to restore maternal and neonatal protection against COVID-19.
评估在妊娠中期接受第三剂（加强剂）辉瑞-生物技术信使 RNA（Pfizer）新型冠状病毒病 2019（COVID-19）疫苗后，分娩时母体和新生儿严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）免疫球蛋白 G（IgG）抗体水平，并将其与在妊娠中期接受两剂疫苗的女性进行比较。
我们对在单一中心分娩病房住院的女性进行了一项前瞻性队列研究，这些女性在妊娠 17-30 周时接受了第三剂辉瑞 COVID-19 疫苗（加强组），且之前未感染过 SARS-CoV-2。在分娩时和出生后脐带血中测量母体和新生儿的抗体水平。将加强组的抗体水平与同一妊娠周龄窗口内接受第二剂疫苗（两剂组）的妊娠女性的历史对照组进行比较。
2021 年 10 月至 2022 年 2 月，在加强接种后平均 15.3±3.9 周时，对 121 名女性及其 109 名新生儿的抗体水平进行了测量。新生儿滴度比母体滴度高两倍，且母体和新生儿出生时的滴度与第三次接种的时间间隔呈负相关。两剂组包括 121 名女性及其 107 名新生儿，在第二次接种后平均 14.6±2.6 周时测量了抗体水平。与两剂组（中位数 [四分位距]：1122[735-1872] AU/mL）相比，加强组的母体抗体滴度中位数 [四分位距]更高（4485[2087-9702] AU/mL）（P<.001）。此外，与两剂组（中位数 [四分位距]：3280[2087-5754] AU/mL）相比，加强组的新生儿抗体滴度中位数 [四分位距]更高（8773[5143-18830] AU/mL）（P<.001）。
与两剂疫苗接种系列相比，在妊娠中期接受辉瑞 COVID-19 疫苗加强剂后，母体和新生儿 SARS-CoV-2 IgG 抗体滴度在第二次接种后明显升高。尽管尚不确定抗体水平是否与保护作用相关，但这些数据支持在妊娠期间进行加强接种以恢复母体和新生儿对 COVID-19 的保护作用的重要性。
