Stolarczuk Jennifer E, Sosa Monica, Pike Mindy, Baranoff Alexis, Lekander Ava, Cho Hye, Goecker Erin A, Greninger Alexander L, Eckert Linda O, Englund Janet A, Kachikis Alisa
University of Washington School of Medicine, Seattle, Washington, United States of America.
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2025 Sep 2;20(9):e0328137. doi: 10.1371/journal.pone.0328137. eCollection 2025.
Maternal immunization relies on active transplacental transfer of immunoglobulin G. However, very little is known about the efficacy of maternal immunization in the setting of multiple gestation. We aimed to investigate transplacental transfer of maternal antibody in pregnancies with multiple gestation including mono- and dichorionic pregnancies by evaluating anti-Spike antibody transfer at delivery.
We conducted a cohort study among individuals with singleton or twin pregnancies who received ≥ 2 doses of an mRNA COVID-19 vaccine before delivery. We tested paired maternal and cord blood samples for anti-Spike antibody levels via Roche Elecsys® immunoassays and used linear regression to evaluate associations between pregnancy type and anti-Spike antibody levels. We included as covariates gestational age at birth, timing of last vaccine dose, number of vaccine doses, and small for gestational age birth weight.
Between 2021-2023, we tested paired maternal and cord samples for anti-Spike antibody from 362 singleton pregnancies and 36 twin pregnancies, of which 12 and 24 were monochorionic and dichorionic, respectively. After adjusting for covariates, maternal and cord anti-Spike antibody concentrations were significantly lower in twin pregnancies compared to singleton pregnancies (beta:-0.91, 95% Confidence Interval [CI]: -1.62,-0.19; p = 0.01. beta -1.20, 95% CI: -2.36,-0.04; p = 0.04), however there was no difference in cord:maternal antibody ratios. After adjusting for covariates, there was no difference in maternal and cord antibody concentrations between dichorionic and monochorionic pregnancies, however, cord:maternal antibody ratios remained significantly lower in monochorionic compared to dichorionic pregnancies (beta:-0.49; 95% CI: -0.86,-0.13; p = 0.01).
Twin and singleton infants have similar cord:maternal maternally derived SARS-CoV-2 antibody ratios after maternal COVID-19 vaccine although maternal and cord antibody concentrations are lower in infants from twin pregnancies and specifically antibody transfer is less efficient in monochorionic pregnancies. Further research is needed to investigate impaired transplacental IgG transfer in high-risk pregnancies.
母体免疫依赖于免疫球蛋白G的主动经胎盘转移。然而，对于多胎妊娠情况下母体免疫的效果知之甚少。我们旨在通过评估分娩时抗刺突抗体的转移情况，研究多胎妊娠（包括单绒毛膜和双绒毛膜妊娠）中母体抗体的经胎盘转移。
我们对在分娩前接受≥2剂mRNA新冠疫苗的单胎或双胎妊娠个体进行了一项队列研究。我们通过罗氏电化学发光免疫分析法检测配对的母体和脐带血样本中的抗刺突抗体水平，并使用线性回归评估妊娠类型与抗刺突抗体水平之间的关联。我们将出生时的胎龄、最后一剂疫苗接种时间、疫苗接种剂量以及小于胎龄儿出生体重作为协变量纳入分析。
在2021年至2023年期间，我们检测了362例单胎妊娠和36例双胎妊娠的配对母体和脐带样本中的抗刺突抗体，其中单绒毛膜和双绒毛膜妊娠分别为12例和24例。在调整协变量后，双胎妊娠中母体和脐带抗刺突抗体浓度显著低于单胎妊娠（β：-0.91，95%置信区间[CI]：-1.62，-0.19；p = 0.01。β -1.20，95% CI：-2.36，-0.04；p = 0.04），然而脐带与母体抗体比值没有差异。在调整协变量后，双绒毛膜和单绒毛膜妊娠的母体和脐带抗体浓度没有差异，但是，与双绒毛膜妊娠相比，单绒毛膜妊娠的脐带与母体抗体比值仍然显著较低（β：-0.49；95% CI：-0.86，-0.13；p = 0.01）。
母体接种新冠疫苗后，双胎和单胎婴儿的脐带与母体来源的严重急性呼吸综合征冠状病毒2抗体比值相似，尽管双胎妊娠婴儿的母体和脐带抗体浓度较低，特别是在单绒毛膜妊娠中抗体转移效率较低。需要进一步研究来调查高危妊娠中经胎盘IgG转移受损的情况。
