Kachikis Alisa B, Rumfelt Kalee, Pike Mindy, Sosa Monica, Stolarczuk Jennifer E, Cho Hye, Eckert Linda O, Martin Emily T, Englund Janet A
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
Open Forum Infect Dis. 2024 Jul 22;11(7):ofae314. doi: 10.1093/ofid/ofae314. eCollection 2024 Jul.
Respiratory syncytial virus (RSV)-associated lower respiratory tract infection contributes significantly to morbidity/mortality worldwide in low birthweight (LBW) infants (<2500 g). Studies have demonstrated decreased maternal immunoglobulin G (IgG) transfer of various antibodies to LBW infants. We aimed to evaluate naturally acquired RSV anti-prefusion F protein (anti-preF) antibody transfer in pregnancies with LBW versus normal birthweight (NBW) infants.
In this cohort study conducted among pregnant individuals and their infants, we tested paired maternal and singleton infant cord samples for RSV anti-preF IgG via an electrochemiluminescence immunoassay, using linear regression to evaluate associations between LBW and anti-preF IgG. Covariates included seasonality, insurance, small-for-gestational-age birthweight, and gestational age at delivery.
We tested maternal/cord RSV anti-preF IgG from 54 and 110 pregnancies with LBW and NBW infants, respectively. Of LBW infants, 22 (40.7%) were born both preterm and with small-for-gestational-age birthweight. The median (interquartile range) gestational age at delivery and birthweight were 34.0 (31.7-37.1) weeks and 1902 (1393-2276) g for LBW infants versus 39.1 (38.3-39.9) weeks and 3323 (3109-3565) g for NBW infants (both < .001). In unadjusted comparisons, preterm infants had significantly lower cord anti-preF IgG levels and cord-maternal IgG ratios compared with full-term infants, while LBW infants had significantly lower cord-maternal IgG ratios than NBW infants (all < .01). After adjustment for covariates, there was no difference in cord-maternal IgG ratios (β =-0.29 [95% confidence interval, -.63 to .05]) between LBW and NBW infants.
We documented robust transfer of maternal RSV anti-preF IgG in pregnancies with both LBW and NBW infants. Further studies are needed to assess immune protection in at-risk infants.
呼吸道合胞病毒（RSV）相关的下呼吸道感染是全球低出生体重（LBW）婴儿（<2500g）发病/死亡的重要原因。研究表明，母体免疫球蛋白G（IgG）向LBW婴儿转移的各种抗体减少。我们旨在评估与低出生体重儿相比，正常出生体重（NBW）儿的妊娠中自然获得的RSV抗融合前F蛋白（抗preF）抗体转移情况。
在这项针对孕妇及其婴儿的队列研究中，我们通过电化学发光免疫分析法检测了配对的母体和单胎婴儿脐带样本中的RSV抗preF IgG，使用线性回归评估LBW与抗preF IgG之间的关联。协变量包括季节、保险、小于胎龄儿出生体重和分娩时的孕周。
我们分别检测了54例LBW婴儿和110例NBW婴儿的母体/脐带RSV抗preF IgG。在LBW婴儿中，22例（40.7%）早产且出生体重小于胎龄。LBW婴儿分娩时的孕周中位数（四分位间距）和出生体重分别为34.0（31.7 - 37.1）周和1902（1393 - 2276）g，而NBW婴儿分别为39.1（38.3 - 39.9）周和3323（3109 - 3565）g（均<0.001）。在未调整的比较中，与足月儿相比，早产儿的脐带抗preF IgG水平和脐带 - 母体IgG比值显著降低，而LBW婴儿的脐带 - 母体IgG比值显著低于NBW婴儿（均<0.01）。在调整协变量后，LBW和NBW婴儿的脐带 - 母体IgG比值没有差异（β=-0.29[95%置信区间,-0.63至0.05]）。
我们记录了LBW和NBW婴儿妊娠中母体RSV抗preF IgG的有效转移。需要进一步研究以评估高危婴儿的免疫保护情况。
