Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain.
Balearic Islands Health Research Institute (IdISBa), Palma, Spain.
Eur J Clin Microbiol Infect Dis. 2024 Apr;43(4):693-702. doi: 10.1007/s10096-024-04773-3. Epub 2024 Feb 7.
To assess neonatal SARS-CoV-2 anti-spike IgG antibody levels after maternal mRNA COVID-19 vaccination and/or infection during pregnancy and evaluate their protective effect.
Prospective observational study, conducted from January 2021 to December 2022. Infants were tested for anti-spike IgG antibodies at birth and then every 3 months until disappearance of titer. A follow-up was done for SARS-CoV-2 infection up to 12 months.
In total, 147 newborns were enrolled with a median (IQR) gestational age of 39.60 weeks (38.3-40.4). Median (IQR) titers in UA/ml at 2 days were higher (P < .001) in newborns of vaccinated 7063.7 (2841.4-14,448.1), than of infected mothers 372.7 (158.00-884.90). Titers dropped significantly during the follow-up but 50% still had a detectable titer at 6 months. A high antibody titer at 2 days led to a longer persistence (HR 0.89, IC 95% 0.83-0.96, P = .004). In total, 36 infants were infected during the first months of life coinciding with the Omicron variant. Fifty percent had detectable antibodies during the infection period. Relationship between high IgG titers and month of infection was inverse (RHO - 0.52, P = .009).
Though a high antibody titer at birth led to longer persistence, no protective effect against infection was found. As newborns are a high risk group for COVID-19, avoiding transmission during the first year of life is important.
评估母亲在孕期接种 mRNA 新冠疫苗和/或感染新冠病毒后新生儿 SARS-CoV-2 刺突 IgG 抗体水平，并评估其保护作用。
前瞻性观察性研究，于 2021 年 1 月至 2022 年 12 月进行。新生儿在出生时和之后每 3 个月检测一次抗刺突 IgG 抗体，直至滴度消失。随访至 12 个月，以了解 SARS-CoV-2 感染情况。
共纳入 147 例新生儿，中位（IQR）胎龄为 39.60 周（38.3-40.4）。出生后 2 天，接种 7063.7 例新生儿 UA/ml 中位数（IQR）滴度较高（P < .001），为 14448.1（2841.4-14,448.1），而感染母亲为 372.7（158.00-884.90）。随访期间滴度显著下降，但 50%的新生儿在 6 个月时仍可检测到滴度。出生后 2 天抗体高滴度与较长的持续时间相关（HR 0.89，95%CI 0.83-0.96，P = .004）。共有 36 例婴儿在生命的头几个月感染，恰逢奥密克戎变异株流行。50%的患儿在感染期间可检测到抗体。高 IgG 滴度与感染月份之间呈负相关（RHO - 0.52，P = .009）。
虽然出生时高抗体滴度可导致较长的持续时间，但未发现对感染有保护作用。由于新生儿是 COVID-19 的高风险人群，因此在生命的第一年避免传播很重要。
