Hamouda Naema I, Amin Ahmed Mostafa, Hasan Mohammed T, Baghagho Ehssan
Neonatology, El-Sahel Teaching Hospital/General Organization for Teaching Hospitals and Institutes, Cairo, EGY.
Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, EGY.
Cureus. 2024 May 2;16(5):e59500. doi: 10.7759/cureus.59500. eCollection 2024 May.
The World Health Organization (WHO) declared COVID-19 a pandemic. The Centers for Disease Control and Prevention (CDC), WHO, and American College of Obstetricians and Gynecologists (ACOG) recommend vaccination of pregnant and lactating women, aiming to protect both mothers and their infants through transplacental and human milk antibody transmission. This study aims to assess the quantity of antibodies in human milk and determine the effect of time, vaccine type, and dose on antibody level. Single-arm prospective observational studies reporting the COVID-19-specific antibody level in human milk after COVID-19 vaccination during pregnancy or lactation were included. PubMed, Scopus, Cochrane, EBSCO, and Web of Science were searched from December 2019 to November 22, 2022. Data were extracted in a uniform Google sheet. A total of 2657 studies were identified. After the removal of duplicates and screening, 24 studies were included in the systematic review and meta-regression. Human milk COVID-19-specific antibody levels increased with subsequent vaccine doses, as reflected by a positive relationship for the second (coefficient=0.91, P-value 0.043 for IgA and coefficient=1.77, P-value 0.009 for IgG) and third (coefficient=1.23, P-value 0.0029 for IgA and coefficient=3.73, P-value 0.0068 for IgG) doses. The antibody level exhibited a weak positive relationship with the follow-up time (coefficient=0.13, P-value 0.0029 for IgA and coefficient=0.18, P-value 0.016 for IgG). Only one of the 38 infants showed detectable COVID-19 IgM and IgA antibody levels in their blood. There was an increase in the neutralizing activity of COVID-19 antibodies in human milk following the COVID-19 vaccination. From the analysis of published data, we found high positive levels of antibodies in human milk that increased with subsequent doses. Additionally, the human milk antibodies exhibit a positive neutralizing effect. Only one infant had detectable COVID-19 IgM+IgA antibodies in the blood. Further research is needed to discuss infant protection through a mother's vaccination.
世界卫生组织(WHO)宣布新冠疫情为大流行。美国疾病控制与预防中心(CDC)、WHO以及美国妇产科医师学会(ACOG)建议孕妇和哺乳期妇女接种疫苗,旨在通过胎盘和母乳抗体传递保护母亲及其婴儿。本研究旨在评估母乳中抗体的数量,并确定时间、疫苗类型和剂量对抗体水平的影响。纳入了报告孕期或哺乳期接种新冠疫苗后母乳中新冠特异性抗体水平的单臂前瞻性观察研究。于2019年12月至2022年11月22日检索了PubMed、Scopus、Cochrane、EBSCO和科学网。数据在统一的谷歌表格中提取。共识别出2657项研究。在去除重复项和筛选后,24项研究被纳入系统评价和Meta回归分析。母乳中新冠特异性抗体水平随后续疫苗剂量增加而升高,如第二次(IgA系数 = 0.91,P值 = 0.043;IgG系数 = 1.77,P值 = 0.009)和第三次(IgA系数 = 1.23,P值 = 0.0029;IgG系数 = 3.73,P值 = 0.0068)剂量呈现正相关关系。抗体水平与随访时间呈弱正相关(IgA系数 = 0.13,P值 = 0.0029;IgG系数 = 0.18,P值 = 0.016)。38名婴儿中只有1名婴儿血液中检测到新冠IgM和IgA抗体水平。接种新冠疫苗后母乳中新冠抗体的中和活性有所增加。通过对已发表数据的分析,我们发现母乳中抗体阳性水平较高,且随后续剂量增加。此外,母乳抗体具有阳性中和作用。只有1名婴儿血液中检测到新冠IgM + IgA抗体。需要进一步研究以探讨通过母亲接种疫苗对婴儿的保护作用。