Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China.
J Med Virol. 2023 Oct;95(10):e29125. doi: 10.1002/jmv.29125.
This study focuses on maternal antibody transfer following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) before or during early pregnancy and its potential protective effects on infants, providing scientific evidence for vaccination strategies. This prospective study tested the samples for SARS-CoV-2 IgG antibody titers and neutralizing capacity and tracked the infections after birth. Perform multivariate analysis of factors influencing antibody transfer rate, newborn antibody titers, and infant infection. Total 87.1% (122/140) women received coronavirus disease 2019 (COVID-19) vaccine before or during early pregnancy, and 28 of them had breakthrough infection. The maternal and neonatal IgG positive rates at delivery were 60.7% (85/140) and 60.8% (87/143), respectively. A positive correlation was found between neonatal and maternal IgG antibody titers. Compared with the median IgG antibody transfer rate of infected pregnant women, that of vaccinated but not infected pregnant women was higher (1.21 versus: 1.53 [two doses], 1.71 [three doses]). However, neonatal IgG antibodies were relatively low (174.91 versus: 0.99 [two doses], 8.18 [three doses]), and their neutralizing capacity was weak. The overall effectiveness of maternal vaccination in preventing infant infection was 27.0%, and three doses had higher effectiveness than two doses (64.3% vs. 19.6%). Multivariate analysises showed that in vaccination group women receiving three doses or in infection group women with longer interval between infection and delivery had a higher antibody transfer rate and neonatal IgG antibody titer. More than half of women vaccinated before or during early pregnancy can achieve effective antibody transfer to newborns. However, the neonatal IgG antibody titer is low and has a weak neutralizing capacity, providing limited protection to infants.
本研究聚焦于孕妇在妊娠早期接种严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗后，母体抗体转移及其对婴儿的潜在保护作用，为疫苗接种策略提供科学依据。本前瞻性研究检测了 SARS-CoV-2 IgG 抗体滴度和中和能力的样本，并跟踪了出生后的感染情况。对影响抗体转移率、新生儿抗体滴度和婴儿感染的因素进行多变量分析。共有 87.1%（122/140）的女性在妊娠早期或妊娠期间接种了 2019 年冠状病毒病（COVID-19）疫苗，其中 28 人发生突破性感染。分娩时母婴 IgG 阳性率分别为 60.7%（140/231）和 60.8%（143/235）。新生儿和产妇 IgG 抗体滴度呈正相关。与感染孕妇的 IgG 抗体转移中位数相比，接种疫苗但未感染孕妇的 IgG 抗体转移率更高（1.21 比：1.53[两剂]，1.71[三剂]）。然而，新生儿 IgG 抗体相对较低（174.91 比：0.99[两剂]，8.18[三剂]），其中和能力较弱。母亲接种疫苗预防婴儿感染的总体有效性为 27.0%，三剂的有效性高于两剂（64.3%比 19.6%）。多变量分析显示，在接种组中接种三剂或在感染组中感染与分娩间隔较长的女性，其抗体转移率和新生儿 IgG 抗体滴度较高。超过一半在妊娠早期或妊娠期间接种疫苗的女性可以有效地将抗体转移给新生儿。然而，新生儿 IgG 抗体滴度较低，中和能力较弱，对婴儿的保护作用有限。
