Université Paris-Saclay, Inserm U1193, AP-HP, Hôpital Paul Brousse, Virology department, Villejuif 94800, France; Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), France.
Université Paris Cité, INSERM CIC-EC 1425, AP-HP, Hôpital Bichat - Claude Bernard, Clinical Research Department, France.
J Clin Virol. 2023 Aug;165:105495. doi: 10.1016/j.jcv.2023.105495. Epub 2023 May 26.
Due to immaturity of their immune system, passive maternal immunization is essential for newborns during their first months of life. Therefore, in the current context of intense circulation of SARS-CoV-2, identifying factors influencing the transfer ratio (TR) of neutralizing antibodies against SARS-CoV-2 (NAb) appears important.
Our study nested in the COVIPREG cohort (NCT04355234), included mothers who had a SARS-CoV-2 PCR positive during their pregnancy and their newborns. Maternal and neonatal NAb levels were measured with the automated iFlash system.
For the 173 mother-infant pairs included in our study, the median gestational age (GA) at delivery was 39.4 weeks of gestation (WG), and 29.7 WG at maternal SARS-CoV-2 infection. Using a multivariate logistic model, having a NAb TR above 1 was positively associated with a longer delay from maternal positive SARS-CoV-2 PCR to delivery (aOR 1.09, 95% CI: 1.03 - 1.17) and with a later GA at delivery (aOR = 1.58, 95% CI: 1.09 - 2.52). It was negatively associated with being a male newborn (aOR 0.21, 95% CI: 0.07 - 0.59). In 3rd trimester SARS-CoV-2 infected mothers, NAb TR was inferior to VZV, toxoplasmosis, CMV, measle and rubella's TR. However, in 1st or 2nd trimester infected mothers, only measle TR was different from NAb TR.
Male newborn of mothers infected by SARS-CoV-2 during their pregnancy appear to have less protection against SARS-CoV-2 in their first months of life than female newborns. Measle TR was superior to NAb TR even in case of 1st or 2nd trimester maternal SARS-CoV-2 infection. Future studies are needed to investigate possible differences in transmission of NAb following infection vs vaccination and its impact on TR.
由于新生儿免疫系统尚未成熟，因此在生命的头几个月中，被动的母体免疫对于新生儿至关重要。因此，在当前 SARS-CoV-2 强烈传播的情况下，确定影响 SARS-CoV-2 中和抗体（NAb）转移率（TR）的因素显得尤为重要。
我们的研究嵌套在 COVIPREG 队列中（NCT04355234），纳入了在怀孕期间 SARS-CoV-2 PCR 阳性的母亲及其新生儿。使用自动化 iFlash 系统测量了母婴的 NAb 水平。
在我们的研究中，有 173 对母婴被纳入，中位分娩时的胎龄（GA）为 39.4 周 GA，母亲 SARS-CoV-2 感染时为 29.7 周 GA。使用多元逻辑模型，NAb TR 大于 1 与从母亲 SARS-CoV-2 PCR 阳性到分娩的时间延迟较长（优势比 1.09，95%CI：1.03-1.17）和分娩时 GA 较晚相关（优势比为 1.58，95%CI：1.09-2.52）。它与新生儿为男性呈负相关（优势比 0.21，95%CI：0.07-0.59）。在妊娠晚期感染 SARS-CoV-2 的母亲中，NAb TR 低于 VZV、弓形虫病、CMV、麻疹和风疹的 TR。然而，在妊娠 1 期或 2 期感染的母亲中，只有麻疹 TR 与 NAb TR 不同。
与女性新生儿相比，在妊娠期间感染 SARS-CoV-2 的母亲的男婴在生命的头几个月中对 SARS-CoV-2 的保护作用似乎较弱。即使在妊娠 1 期或 2 期感染 SARS-CoV-2 的情况下，麻疹 TR 也优于 NAb TR。未来的研究需要调查感染后与接种疫苗后 NAb 的传播差异及其对 TR 的影响。
