Pernet Olivier, Frederick Toinette, Adili Amila, Hudgins Jay, Anthony Patricia, McCaney Gwyndolyn, Mack Wendy J, Noriega Eunice, Lopez Jennifer, Balog Steven, Biniwale Manoj, Yeh Amy, Bearden Allison, Ramanathan Rangasamy, Kovacs Andrea
Maternal, Child, and Adolescent Center for Infectious Diseases and Virology, Division of Pediatric Infectious Diseases, University of Southern California, Keck School of Medicine of USC, and Los Angeles General Medical Center, Los Angeles, CA, USA.
Southern California Clinical and Translational Science Institute (SC-CTSI), University of Southern California, Los Angeles, CA, USA.
Nat Commun. 2025 Apr 14;16(1):3551. doi: 10.1038/s41467-025-58768-5.
It is estimated that in utero SARS-CoV-2 infection is rare. However, few studies have systematically assessed for IgA and IgM antibodies indicating potential in utero response to SARS-CoV-2 infection using multi-isotype serology, and no studies have assessed in utero infection markers in relation to circulating variants. Between October 21, 2021 and February 15, 2023, remnant cord blood samples (CBS) from neonates born at a single hospital in Los Angeles, were systematically tested for serological markers suggesting in utero infection. SARS-CoV-2 specific fetal IgA and/or IgM antibodies were detected in 28.7% (298/1038 CBS, 95% CI: 26.0, 31.6), higher than previous in utero infection estimates that used only PCR and/or IgM. Importantly, the probability of detecting markers of in utero infection varied by month (P-value = 0.0144). The prevalence of fetal IgA/IgM varied with the emergence of new variants, increasing during the BA.1 wave with a peak in February 2022 at 36% (18/50, 95% CI: 22.7-49.3) and again during the BA.4/5 wave, with a peak at 48.8% in September 2022 (39/80, 95% CI 37.8-59.7), suggesting variant-related fluctuations. These data suggest it may be useful to identify SARS-Cov-2 in utero exposure at birth so these newborns may be more closely followed for adverse clinical outcomes.
据估计，子宫内感染SARS-CoV-2的情况很少见。然而，很少有研究使用多亚型血清学系统评估表明子宫内对SARS-CoV-2感染可能产生反应的IgA和IgM抗体，并且没有研究评估与循环变异株相关的子宫内感染标志物。在2021年10月21日至2023年2月15日期间，对洛杉矶一家医院出生的新生儿的残余脐带血样本（CBS）进行了系统检测，以寻找表明子宫内感染的血清学标志物。在28.7%（298/1038个CBS，95%置信区间：26.0，31.6）的样本中检测到了SARS-CoV-2特异性胎儿IgA和/或IgM抗体，高于之前仅使用PCR和/或IgM的子宫内感染估计值。重要的是，检测子宫内感染标志物的概率因月份而异（P值 = 0.0144）。胎儿IgA/IgM的患病率随新变异株的出现而变化，在BA.1浪潮期间增加，2022年2月达到峰值，为36%（18/50，95%置信区间：22.7 - 49.3），在BA.4/5浪潮期间再次增加，2022年9月达到峰值，为48.8%（39/80，95%置信区间37.8 - 59.7），表明存在与变异株相关的波动。这些数据表明，在出生时识别子宫内接触SARS-CoV-2的情况可能有用，这样这些新生儿可能会因不良临床结局而得到更密切的随访。
