Hayashi Takuma, Sano Kenji, Konishi Ikuo
Cancer Medicine, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa Mukaihatake, Fushimi-ku, Kyoto-City 612-8555, Kyoto, Japan.
Medical R&D Promotion Project, The Japan Agency for Medical Research and Development (AMED), Chuo-ku, Tokyo 103-0022, Japan.
Infect Dis Rep. 2024 May 27;16(3):481-490. doi: 10.3390/idr16030036.
Coronavirus disease 2019 (COVID-19) can lead to severe respiratory illness, rapid disease progression, and higher rates of intensive care unit admission in pregnant women. Infection during pregnancy is associated with an increased risk of preterm delivery, cesarean section, fetal dysfunction, preeclampsia, and perinatal death. Vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from pregnant women to their fetuses has also been observed. Although severe infections in neonates and infants are rare, newborns can experience serious consequences from COVID-19 due to their suboptimal humoral immune system protection. The amino acids in the structural proteins of SARS-CoV-2 are constantly mutating. Since around January 2023, COVID-19, caused by omicron-type SARS-CoV-2 variants, has been prevalent globally. These variants can evade the immune response triggered by traditional mRNA-based COVID-19 vaccines, such as BNT162b2. Therefore, vaccination with BNT162b2 XBB.1.5, which provides protection against omicron-type SARS-CoV-2 variants, is recommended.
This retrospective cohort study included 148 pregnant women who received the BNT162b2 XBB.1.5 vaccine at 30 partner medical institutions from September 2023 to January 2024. We examined the titers of anti-spike glycoprotein SARS-CoV-2 immunoglobin G (IgG) and IgA in the blood and umbilical cord blood obtained from the participants using ELISA.
Anti-spike glycoprotein SARS-CoV-2 IgG and IgA titers were highest in the blood and cord blood at late gestational age (28-34 weeks). No serious side effects or adverse events were observed in either the pregnant women or their newborns.
Pregnant women who received the BNT162b2 XBB.1.5 vaccine during gestational weeks 28 to 34 had the highest titers of anti-omicron SARS-CoV-2 variant antibodies in their blood. Moreover, these antibodies were transferred to their umbilical cord blood. To validate our findings, large cohort clinical studies involving numerous pregnant women are warranted.
This study was funded by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS) and Grants-in-Aid for Medical Research from the Japan Agency for Medical Research and Development (AMED).
2019年冠状病毒病（COVID-19）可导致孕妇出现严重的呼吸道疾病、疾病进展迅速以及重症监护病房收治率升高。孕期感染与早产、剖宫产、胎儿功能障碍、子痫前期及围产期死亡风险增加有关。还观察到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可从孕妇垂直传播至胎儿。虽然新生儿和婴儿的严重感染很少见，但由于其体液免疫系统保护欠佳，新生儿感染COVID-19可能会产生严重后果。SARS-CoV-2结构蛋白中的氨基酸不断发生突变。自2023年1月左右以来，由奥密克戎型SARS-CoV-2变体引起的COVID-19在全球流行。这些变体可逃避传统的基于mRNA的COVID-19疫苗（如BNT162b2）引发的免疫反应。因此，建议接种可预防奥密克戎型SARS-CoV-2变体的BNT162b2 XBB.1.5疫苗。
这项回顾性队列研究纳入了2023年9月至2024年1月期间在30家合作医疗机构接种BNT162b2 XBB.1.5疫苗的148名孕妇。我们使用酶联免疫吸附测定法（ELISA）检测了参与者血液和脐带血中抗SARS-CoV-2刺突糖蛋白免疫球蛋白G（IgG）和IgA的滴度。
妊娠晚期（28 - 34周）时，血液和脐带血中的抗SARS-CoV-2刺突糖蛋白IgG和IgA滴度最高。孕妇及其新生儿均未观察到严重副作用或不良事件。
在妊娠第28至34周期间接种BNT162b2 XBB.1.5疫苗的孕妇，其血液中抗奥密克戎SARS-CoV-2变体抗体滴度最高。此外，这些抗体转移至了她们的脐带血中。为验证我们的研究结果，有必要开展涉及众多孕妇的大型队列临床研究。
本研究由日本学术振兴会（JSPS）的科研资助金以及日本医疗研究与开发机构（AMED）的医学研究资助金提供资金支持。
