Mendenhall Eric, Hogan Mary Beth, Nudelman Matthew, Preston Deborah L, Weese Hayley, Muckleroy Garrett, Needens Jordan, Addicott Katherine, Haas Jessica Dailey, Roybal Ashlee, Miller Dustin, Cottrell Jesse, Massey Cynthia, Govindaswami Balaji
Department of Pediatrics, Marshall University, Joan C Edwards School of Medicine, Huntington, WV, United States.
Department of Obstetrics and Gynecology, Marshall University, Joan C Edwards School of Medicine, Huntington, WV, United States.
Front Pediatr. 2023 Mar 16;11:1092561. doi: 10.3389/fped.2023.1092561. eCollection 2023.
SARS-CoV-2 is known to manifest a robust innate immune response. However, little is known about inflammatory influences from maternal SARS-CoV-2 infection or maternal mRNA vaccination upon the fetus. In addition, it is unknown if Vitamin D deficiency influences fetal homeostasis or if an anti-inflammatory mechanism to the development of possible innate cytokines or acute phase reactants by the maternal/fetal dyad, in the form of cortisol elevations, occur. In addition, effects on Complete Blood Count (CBC) are not known.
To evaluate the neonatal acute phase reactants and anti-inflammatory responses after maternal SARS-CoV-2 disease or mRNA vaccination.
Samples and medical records reviews from mother/baby dyads ( = 97) were collected consecutively, and were categorized into 4 groups; no SARS-CoV-2 or vaccination exposure (Control), Vaccinated mothers, maternal SARS-CoV-2 disease positive/IgG titer positive fetal blood, and maternal SARS-CoV-2 positive/IgG titer negative fetal blood. SARS-CoV-2 IgG/IgM/IgA titers, CBC, CRP, ferritin, cortisol, and Vitamin D were obtained to examine the possible development of an innate immune response and possible anti-inflammatory response. Student's -test, Wilcoxon rank-sum, and Chi-squared with Bonferroni corrections were used to compare groups. Multiple imputations were performed for missing data.
Cortisol was higher in babies of both mothers who were vaccinated ( = 0.001) and SARS-CoV-2 positive/IgG positive ( = 0.009) as compared to the control group suggesting an attempt to maintain homeostasis in these groups. Measurements of ferritin, CRP, and vitamin D did not reach statistical significance. CBC showed no variation, except for the mean platelet volume (MPV), which was elevated in babies whose mothers were vaccinated ( = 0.003) and SARS-CoV-2 positive/IgG positive ( = 0.007) as compared to the control group.
Acute phase reactant elevations were not noted in our neonates. Vitamin D levels were unchanged from homeostatic levels. Cord blood at birth, showed Cortisol and MPV higher in vaccinated and SARS-CoV-2 IgG positive mother/baby dyads as compared to the Control group, indicating that possible anti-inflammatory response was generated. The implication of possible inflammatory events and subsequent cortisol and/or MPV elevation effects upon the fetus after SARS-CoV-2 disease or vaccination is unknown and merits further investigation.
已知严重急性呼吸综合征冠状病毒2（SARS-CoV-2）会引发强烈的先天性免疫反应。然而，关于母体感染SARS-CoV-2或母体mRNA疫苗接种对胎儿的炎症影响知之甚少。此外，尚不清楚维生素D缺乏是否会影响胎儿内环境稳定，或者母体/胎儿二元组是否会通过皮质醇升高的形式对可能产生的先天性细胞因子或急性期反应物的发展产生抗炎机制。此外，对全血细胞计数（CBC）的影响也不清楚。
评估母体感染SARS-CoV-2疾病或接种mRNA疫苗后新生儿的急性期反应物和抗炎反应。
连续收集母婴二元组（n = 97）的样本和病历，并分为4组；未接触SARS-CoV-2或疫苗（对照组）、接种疫苗的母亲、母体SARS-CoV-2疾病阳性/IgG滴度阳性的胎儿血液，以及母体SARS-CoV-2阳性/IgG滴度阴性的胎儿血液。获取SARS-CoV-2 IgG/IgM/IgA滴度、CBC、CRP、铁蛋白、皮质醇和维生素D，以检查先天性免疫反应和可能的抗炎反应的可能发展情况。使用学生t检验、Wilcoxon秩和检验以及经Bonferroni校正的卡方检验进行组间比较。对缺失数据进行多次插补。
与对照组相比，接种疫苗的母亲（p = 0.001）和SARS-CoV-2阳性/IgG阳性（p = 0.009）的母亲所生婴儿的皮质醇水平较高，表明这些组试图维持内环境稳定。铁蛋白、CRP和维生素D的测量未达到统计学显著性。CBC除平均血小板体积（MPV）外无变化，与对照组相比，接种疫苗的母亲（p = 0.003）和SARS-CoV-2阳性/IgG阳性（p = 0.007）的母亲所生婴儿的MPV升高。
我们的新生儿未发现急性期反应物升高。维生素D水平与内环境稳定水平相比没有变化。与对照组相比，接种疫苗和SARS-CoV-2 IgG阳性的母婴二元组出生时的脐带血显示皮质醇和MPV较高，表明产生了可能的抗炎反应。SARS-CoV-2疾病或疫苗接种后可能的炎症事件以及随后的皮质醇和/或MPV升高对胎儿的影响尚不清楚，值得进一步研究。
