Utility of Newborn Dried Blood Spots to Ascertain Seroprevalence of SARS-CoV-2 Antibodies Among Individuals Giving Birth in New York State, November 2019 to November 2021.
Utility of Newborn Dried Blood Spots to Ascertain Seroprevalence of SARS-CoV-2 Antibodies Among Individuals Giving Birth in New York State, November 2019 to November 2021.
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DOI：
10.1001/jamanetworkopen.2022.27995
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发表时间：
2022-08-01
影响因子：
13.8
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中科院分区：
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新生儿干血斑 (DBS) 样本分析能否用于监测婴儿和分娩个体中的 SARS-CoV-2 血清阳性率？在这项重复横断面研究中，对 2019 年 11 月 1 日至 2021 年 11 月 30 日在纽约州出生的 415~293 名婴儿的 DBS 样本进行了 SARS-CoV-2 抗体分析。全州和地区血清流行率数据反映了纽约州这一时期育龄女性报告的 COVID-19 病例和疫苗接种情况的波动。这些发现表明，对新生儿 DBS 样本进行抗体检测是对最近分娩的个体中 SARS-CoV-2 血清阳性率进行大规模监测的有效方法。这项横断面研究探讨了使用新生儿干血斑检测来确定纽约州孕妇中 SARS-CoV-2 的患病率。血清调查可用于监测 COVID-19 和疫苗接种的人口水平动态。从婴儿收集的干血斑 (DBS) 含有母体 IgG 抗体，可用于最近分娩的个体的血清检查。旨在检查纽约州孕妇中 SARS-CoV-2 抗体的流行情况，确定 SARS-CoV-2 抗体状态与母婴特征之间的关联，并检测该人群中的 COVID-19 疫苗接种情况。进行了一项基于人群的重复横断面研究，以检测 SARS-CoV-2 核衣壳 (N) 和刺突 (S) IgG 抗体。对 2019 年 11 月 1 日至 2021 年 11 月 30 日期间提交给纽约州新生儿筛查计划的去识别化 DBS 样本和数据进行了分析。产前接触 SARS-CoV-2 抗体。使用微球免疫测定法测量针对 SARS-CoV-2 N 和 S 抗原的 IgG 抗体的存在。按地理区域对数据进行分析，并与育龄女性（15-44 岁）报告的 COVID-19 病例和疫苗接种情况进行比较。数据按婴儿出生体重、胎龄、产妇年龄和多胞胎状态进行分层。对 415~293 名婴儿（中位 [IQR] 年龄，1.04 [1.00-1.20] 天；210~805 [51.1%] 男性）的干血斑样本进行了 SARS-CoV-2 抗体分析。纽约州首例已知的抗体阳性婴儿于 2020 年 3 月 29 日出生。SARS-CoV-2 血清阳性率反映了疫苗接种前阶段育龄女性中全州和地区性的 COVID-19 病例。从 2021 年 2 月到 11 月，S 血清流行率与纽约州每个地区和整个州的累积疫苗接种量密切相关 (rs = 0.92-1.00，P ≤ .001)。与正常出生体重的新生儿相比，极低出生体重新生儿（S 720 [14.8%]，N 138 [2.8%]，P < .001）和低出生体重（S 5160 [19.3%]，N 1233 [4.6%]，P = .009）新生儿的 S 和 N 血清阳性率显着较低（S 为 77 116 [20.1%]，N 为 19 872 [5.2%]）。与单胎相比，多胎的 N 血清阳性率较低，而 S 的血清阳性率较高（比值比 [OR]，0.84；95% CI，0.75-0.94；N 和 OR，P = .002，1.24；95% CI，1.18-1.31；S 的 P < .001）与单胎以及母亲年龄大于30 岁（OR，0.87；95% CI，0.80-0.94；N 和 OR，1.17 P < .001；95% CI，1.11-1.23；S P < .001）与 20 岁以下相比。在这项研究中，新生儿 DBS 样本中的血清阳性率反映了研究期间育龄妇女的 COVID-19 病例波动和疫苗接种情况。这些结果证明了使用新生儿 DBS 检测来估计怀孕个体中 SARS-CoV-2 血清流行率的效用。
Can analysis of newborn dried blood spot (DBS) samples be used to monitor SARS-CoV-2 seroprevalence in infants and individuals giving birth? In this repeated cross-sectional study, DBS samples from 415 293 infants born in New York State from November 1, 2019, to November 30, 2021, were analyzed for SARS-CoV-2 antibodies. Statewide and regional seroprevalence data reflect the fluctuations in reported COVID-19 cases and vaccinations among reproductive-aged females during this period in New York State. These findings suggest that antibody testing of newborn DBS samples is an effective way to conduct large-scale monitoring of SARS-CoV-2 seroprevalence among individuals recently giving birth. This cross-sectional study examines the use of newborn dried blood spot testing in determining the SARS-CoV-2 prevalence among pregnant individuals in New York State. Serosurveys can be used to monitor population-level dynamics of COVID-19 and vaccination. Dried blood spots (DBSs) collected from infants contain maternal IgG antibodies and are useful for serosurveys of individuals recently giving birth. To examine SARS-CoV-2 antibody prevalence in pregnant individuals in New York State, identify associations between SARS-CoV-2 antibody status and maternal and infant characteristics, and detect COVID-19 vaccination among this population. A population-based, repeated cross-sectional study was conducted to detect SARS-CoV-2 nucleocapsid (N) and spike (S) IgG antibodies. Deidentified DBS samples and data submitted to the New York State Newborn Screening Program between November 1, 2019, and November 30, 2021, were analyzed. Prenatal exposure to SARS-CoV-2 antibodies. The presence of IgG antibodies to SARS-CoV-2 N and S antigens was measured using a microsphere immunoassay. Data were analyzed by geographic region and compared with reported COVID-19 cases and vaccinations among reproductive-aged females (15-44 years of age). Data were stratified by infant birth weight, gestational age, maternal age, and multiple birth status. Dried blood spot samples from 415 293 infants (median [IQR] age, 1.04 [1.00-1.20] days; 210 805 [51.1%] male) were analyzed for SARS-CoV-2 antibodies. The first known antibody-positive infant in New York State was born on March 29, 2020. SARS-CoV-2 seroprevalence reflected statewide and regional COVID-19 cases among reproductive-aged females in the prevaccine period. From February through November 2021, S seroprevalence was strongly correlated with cumulative vaccinations in each New York State region and in the state overall (rs = 0.92-1.00, P ≤ .001). S and N seroprevalences were significantly lower in newborns with very low birth weight (720 [14.8%] for S and 138 [2.8%] for N, P < .001) and low birth weight (5160 [19.3%] for S and 1233 [4.6%] for N, P = .009) compared with newborns with normal birth weight (77 116 [20.1%] for S and 19 872 [5.2%] for N). Lower N and higher S seroprevalences were observed in multiple births (odds ratio [OR], 0.84; 95% CI, 0.75-0.94; P = .002 for N and OR, 1.24; 95% CI, 1.18-1.31; P < .001 for S) vs single births and for maternal age older than 30 years (OR, 0.87; 95% CI, 0.80-0.94; P < .001 for N and OR, 1.17; 95% CI, 1.11-1.23; P < .001 for S) vs younger than 20 years. In this study, seroprevalence in newborn DBS samples reflected COVID-19 case fluctuations and vaccinations among reproductive-aged women during the study period. These results demonstrate the utility of using newborn DBS testing to estimate SARS-CoV-2 seroprevalence in pregnant individuals.