Cargando…
Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates
BACKGROUND: Pregnant women and their neonates represent 2 vulnerable populations with an interdependent immune system that are highly susceptible to viral infections. The immune response of pregnant women to severe acute respiratory syndrome coronavirus 2 and the interplay of how the maternal immune...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825873/ https://www.ncbi.nlm.nih.gov/pubmed/33497654 http://dx.doi.org/10.1016/j.ajog.2021.01.016 |
_version_ | 1783640409887473664 |
---|---|
author | Kubiak, Jeffrey M. Murphy, Elisabeth A. Yee, Jim Cagino, Kristen A. Friedlander, Rachel L. Glynn, Shannon M. Matthews, Kathy C. Jurkiewicz, Magdalena Sukhu, Ashley C. Zhao, Zhen Prabhu, Malavika Riley, Laura E. Yang, Yawei J. |
author_facet | Kubiak, Jeffrey M. Murphy, Elisabeth A. Yee, Jim Cagino, Kristen A. Friedlander, Rachel L. Glynn, Shannon M. Matthews, Kathy C. Jurkiewicz, Magdalena Sukhu, Ashley C. Zhao, Zhen Prabhu, Malavika Riley, Laura E. Yang, Yawei J. |
author_sort | Kubiak, Jeffrey M. |
collection | PubMed |
description | BACKGROUND: Pregnant women and their neonates represent 2 vulnerable populations with an interdependent immune system that are highly susceptible to viral infections. The immune response of pregnant women to severe acute respiratory syndrome coronavirus 2 and the interplay of how the maternal immune response affects the neonatal passive immunity have not been studied systematically. OBJECTIVE: We characterized the serologic response in pregnant women and studied how this serologic response correlates with the maternal clinical presentation and with the rate and level of passive immunity that the neonate received from the mother. STUDY DESIGN: Women who gave birth and who tested positive for immunoglobulin M or immunoglobulin G against severe acute respiratory syndrome coronavirus 2 using semiquantitative detection in a New York City hospital between March 22, 2020, and May 31, 2020, were included in this study. A retrospective chart review of the cases that met the inclusion criteria was conducted to determine the presence of coronavirus disease 2019 symptoms and the use of oxygen support. Serology levels were compared between the symptomatic and asymptomatic patients using a Welch 2 sample t test. Further chart review of the same patient cohort was conducted to identify the dates of self-reported onset of coronavirus disease 2019 symptoms and the timing of the peak immunoglobulin M and immunoglobulin G antibody levels after symptom onset was visualized using local polynomial regression smoothing on log(2)-scaled serologic values. To study the neonatal serology response, umbilical cord blood samples of the neonates born to the subset of serology positive pregnant women were tested for serologic antibody responses. The maternal antibody levels of serology positive vs the maternal antibody levels of serology negative neonates were compared using the Welch 2 sample t test. The relationship between the quantitative maternal and quantitative neonatal serologic data was studied using a Pearson correlation and linear regression. A multiple linear regression analysis was conducted using maternal symptoms, maternal serology levels, and maternal use of oxygen support to determine the predictors of neonatal immunoglobulin G levels. RESULTS: A total of 88 serology positive pregnant women were included in this study. The antibody levels were higher in symptomatic pregnant women than in asymptomatic pregnant women. Serology studies in 34 women with symptom onset data revealed that the maternal immunoglobulin M and immunoglobulin G levels peak around 15 and 30 days after the onset of coronavirus disease 2019 symptoms, respectively. Furthermore, studies of 50 neonates born to this subset of serology positive women showed that passive immunity in the form of immunoglobulin G is conferred in 78% of all neonates. The presence of passive immunity is dependent on the maternal antibody levels, and the levels of neonatal immunoglobulin G correlate with maternal immunoglobulin G levels. The maternal immunoglobulin G levels and maternal use of oxygen support were predictive of the neonatal immunoglobulin G levels. CONCLUSION: We demonstrated that maternal serologies correlate with symptomatic maternal infection, and higher levels of maternal antibodies are associated with passive neonatal immunity. The maternal immunoglobulin G levels and maternal use of oxygen support, a marker of disease severity, predicted the neonatal immunoglobulin G levels. These data will further guide the screening for this uniquely linked population of mothers and their neonates and can aid in developing maternal vaccination strategies. |
format | Online Article Text |
id | pubmed-7825873 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78258732021-01-25 Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates Kubiak, Jeffrey M. Murphy, Elisabeth A. Yee, Jim Cagino, Kristen A. Friedlander, Rachel L. Glynn, Shannon M. Matthews, Kathy C. Jurkiewicz, Magdalena Sukhu, Ashley C. Zhao, Zhen Prabhu, Malavika Riley, Laura E. Yang, Yawei J. Am J Obstet Gynecol Original Research BACKGROUND: Pregnant women and their neonates represent 2 vulnerable populations with an interdependent immune system that are highly susceptible to viral infections. The immune response of pregnant women to severe acute respiratory syndrome coronavirus 2 and the interplay of how the maternal immune response affects the neonatal passive immunity have not been studied systematically. OBJECTIVE: We characterized the serologic response in pregnant women and studied how this serologic response correlates with the maternal clinical presentation and with the rate and level of passive immunity that the neonate received from the mother. STUDY DESIGN: Women who gave birth and who tested positive for immunoglobulin M or immunoglobulin G against severe acute respiratory syndrome coronavirus 2 using semiquantitative detection in a New York City hospital between March 22, 2020, and May 31, 2020, were included in this study. A retrospective chart review of the cases that met the inclusion criteria was conducted to determine the presence of coronavirus disease 2019 symptoms and the use of oxygen support. Serology levels were compared between the symptomatic and asymptomatic patients using a Welch 2 sample t test. Further chart review of the same patient cohort was conducted to identify the dates of self-reported onset of coronavirus disease 2019 symptoms and the timing of the peak immunoglobulin M and immunoglobulin G antibody levels after symptom onset was visualized using local polynomial regression smoothing on log(2)-scaled serologic values. To study the neonatal serology response, umbilical cord blood samples of the neonates born to the subset of serology positive pregnant women were tested for serologic antibody responses. The maternal antibody levels of serology positive vs the maternal antibody levels of serology negative neonates were compared using the Welch 2 sample t test. The relationship between the quantitative maternal and quantitative neonatal serologic data was studied using a Pearson correlation and linear regression. A multiple linear regression analysis was conducted using maternal symptoms, maternal serology levels, and maternal use of oxygen support to determine the predictors of neonatal immunoglobulin G levels. RESULTS: A total of 88 serology positive pregnant women were included in this study. The antibody levels were higher in symptomatic pregnant women than in asymptomatic pregnant women. Serology studies in 34 women with symptom onset data revealed that the maternal immunoglobulin M and immunoglobulin G levels peak around 15 and 30 days after the onset of coronavirus disease 2019 symptoms, respectively. Furthermore, studies of 50 neonates born to this subset of serology positive women showed that passive immunity in the form of immunoglobulin G is conferred in 78% of all neonates. The presence of passive immunity is dependent on the maternal antibody levels, and the levels of neonatal immunoglobulin G correlate with maternal immunoglobulin G levels. The maternal immunoglobulin G levels and maternal use of oxygen support were predictive of the neonatal immunoglobulin G levels. CONCLUSION: We demonstrated that maternal serologies correlate with symptomatic maternal infection, and higher levels of maternal antibodies are associated with passive neonatal immunity. The maternal immunoglobulin G levels and maternal use of oxygen support, a marker of disease severity, predicted the neonatal immunoglobulin G levels. These data will further guide the screening for this uniquely linked population of mothers and their neonates and can aid in developing maternal vaccination strategies. Elsevier Inc. 2021-07 2021-01-23 /pmc/articles/PMC7825873/ /pubmed/33497654 http://dx.doi.org/10.1016/j.ajog.2021.01.016 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Research Kubiak, Jeffrey M. Murphy, Elisabeth A. Yee, Jim Cagino, Kristen A. Friedlander, Rachel L. Glynn, Shannon M. Matthews, Kathy C. Jurkiewicz, Magdalena Sukhu, Ashley C. Zhao, Zhen Prabhu, Malavika Riley, Laura E. Yang, Yawei J. Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title | Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title_full | Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title_fullStr | Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title_full_unstemmed | Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title_short | Severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
title_sort | severe acute respiratory syndrome coronavirus 2 serology levels in pregnant women and their neonates |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825873/ https://www.ncbi.nlm.nih.gov/pubmed/33497654 http://dx.doi.org/10.1016/j.ajog.2021.01.016 |
work_keys_str_mv | AT kubiakjeffreym severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT murphyelisabetha severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT yeejim severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT caginokristena severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT friedlanderrachell severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT glynnshannonm severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT matthewskathyc severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT jurkiewiczmagdalena severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT sukhuashleyc severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT zhaozhen severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT prabhumalavika severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT rileylaurae severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates AT yangyaweij severeacuterespiratorysyndromecoronavirus2serologylevelsinpregnantwomenandtheirneonates |