Bentes Aline Almeida, Mara Gonçalves de Oliveira Azevedo Vivian, Lemos Stela Maris Aguiar, Pinheiro Gabriela Soutto Mayor Assumpção, Araújo Martins Isadora de, Cotta Nicholas Henrique Silva, Martins Dos Santos Oliveira Rafaela, Lousado Mesquita Gabriela, Januário Gabriela Cintra, Januário José Nélio, Shankar Anuraj H, Lindgren Alves Claudia Regina
Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, Minas Gerais, Brazil.
Universidade Federal de Uberlândia, Escola de Educação Física e Fisioterapia, Uberlândia, Minas Gerais, Brazil.
Rev Inst Med Trop Sao Paulo. 2025 Apr 14;67:e29. doi: 10.1590/S1678-9946202567029. eCollection 2025.
Early infant immunity to SARS-CoV-2 depends on maternofetal transfer of antibodies. We aimed to analyze the factors modulating the maternofetal transfer of anti-SARS-CoV-2 IgG antibodies following gestational infection during the pandemic in Brazil (April-August 2021). We conducted a retrospective and prospective cohort study involving 509 mother-child dyads tested simultaneously for IgG anti-nucleocapsid antibodies during universal neonatal screening. There were 341 seronegative dyads and 168 seropositive ones. Seropositive neonates were retested two to three months later. We examined the association of neonatal serological status and IgG concentrations with gestational mRNA vaccination, timing of maternal infection, neonatal conditions, and gender. Gestational SARS-CoV-2 infection predicted neonatal IgG seropositivity (OR=3.97; 95%CI=2.69-5.88). Maternal infection in the first, second, or third trimester was associated with progressively greater seropositivity in neonates (34.4%, 51.6%, and 58.2%, respectively; p=0.03). Among seropositive neonates, IgG concentration was higher when mothers reported they had COVID-19 during pregnancy (p=0.04) and tended to be lower in girls (p=0.06). More than half of the seropositive neonates remained seropositive two to three months later (54.1%), which was associated with both maternal and neonatal IgG concentration at birth (p<0.001). Higher neonatal IgG concentrations at birth were associated with the persistence of anti-N IgG antibodies for two to three months in more than half of the seropositive newborns. This study provides an additional understanding of the dynamics of maternofetal antibody transfer.
婴儿早期对SARS-CoV-2的免疫力取决于抗体的母胎转移。我们旨在分析在巴西疫情期间（2021年4月至8月）妊娠期感染后调节抗SARS-CoV-2 IgG抗体母胎转移的因素。我们进行了一项回顾性和前瞻性队列研究，纳入了509对母婴二元组，在新生儿普遍筛查期间同时检测了抗核衣壳抗体IgG。其中有341对血清阴性二元组和168对血清阳性二元组。血清阳性的新生儿在两到三个月后重新检测。我们研究了新生儿血清学状态和IgG浓度与妊娠期mRNA疫苗接种、母亲感染时间、新生儿状况和性别的关联。妊娠期SARS-CoV-2感染可预测新生儿IgG血清阳性（OR=3.97；95%CI=2.69-5.88）。母亲在孕早期、孕中期或孕晚期感染与新生儿血清阳性率逐渐升高相关（分别为34.4%、51.6%和58.2%；p=0.03）。在血清阳性的新生儿中，当母亲报告孕期感染新冠病毒时，IgG浓度较高（p=0.04），女孩的IgG浓度往往较低（p=0.06）。超过一半的血清阳性新生儿在两到三个月后仍保持血清阳性（54.1%），这与出生时母亲和新生儿的IgG浓度均有关（p<0.001）。出生时新生儿较高的IgG浓度与超过一半的血清阳性新生儿在两到三个月内抗N IgG抗体的持续存在有关。本研究为母胎抗体转移的动态变化提供了进一步的认识。
