Maternal-neonatal transfer of SARS-CoV-2 immunoglobulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy.
Maternal-neonatal transfer of SARS-CoV-2 immunoglobulin G antibodies among parturient women treated with BNT162b2 messenger RNA vaccine during pregnancy.
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DOI：
10.1016/j.ajogmf.2021.100492
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发表时间：
2022-01
影响因子：
6.3
通讯作者：
Yinon Y
中科院分区：
文献类型：
--
作者：
Nir O;Schwartz A;Toussia-Cohen S;Leibovitch L;Strauss T;Asraf K;Doolman R;Sharabi S;Cohen C;Lustig Y;Regev-Yochay G;Yinon Y
孕妇被排除在最初的COVID-19信使RNA疫苗试验之外，这使人们对孕妇接种疫苗的益处产生了疑虑，因此对疫苗在这一人群中的疗效知之甚少。确定SARS-CoV-2抗体在接种疫苗的临产妇女中的母婴经胎盘转移。纳入了COVID-19康复患者的对照组，以比较接种疫苗和康复患者之间的免疫球蛋白G水平。这是一项前瞻性队列研究，于2021年2月至3月在以色列的一家三级医疗中心进行;纳入了妊娠期间接种BNT 162 b2信使RNA疫苗的产妇，并与COVID-19康复的产妇进行了比较。SARS-CoV-2免疫球蛋白G抗体在母亲和脐带血清、新生儿干血斑样本和母乳样本中进行测量。主要目的是确定新生儿脐带血和干血斑样本是否对SARS-CoV-2抗体呈阳性，并评估转移率，转移率定义为脐带血免疫球蛋白G除以母体免疫球蛋白G水平。该研究包括64名接种疫苗的产妇和11名怀孕期间患有COVID-19的产妇。所有母体血清样本和98.3%的脐带血血清样本均为SARS-Cov-2免疫球蛋白G阳性，中位浓度分别为26.1（四分位数范围，22.0-39.7）和20.2（四分位数范围，12.7-29.0）。同样，96.4%的新生儿血斑样本和所有母乳样本对SARS-CoV-2免疫球蛋白G呈阳性，中位浓度分别为11.0（四分位距，7.2-12.8）和4.9（四分位距，3.8-6.0）。母亲血清SARS-CoV-2免疫球蛋白G水平与脐带血（r=0.483; P= 0.0001）、新生儿血斑（r=0.515; P= 0.004）和母乳（r=0.396; P= 0.005）SARS-CoV-2免疫球蛋白G水平之间存在显著正相关。SARS-COV-2免疫球蛋白G的胎盘转移率中位数为0.77。接种疫苗和康复的COVID-19患者的比较显示，接种疫苗的妇女的母体血清和脐带血中SARS-CoV-2免疫球蛋白G水平显著较高（P<.0001）。我们的研究表明，SARS-CoV-2免疫球蛋白G在妊娠期间接种BNT 162 b2信使RNA疫苗的妇女中有效地通过胎盘转移到新生儿中，母体血清和脐带血抗体浓度之间呈正相关。除了保护母亲免受COVID-19的侵害外，该疫苗还可提供新生儿体液免疫。
The exclusion of pregnant women from initial COVID-19 messenger RNA vaccine trials raised hesitancy regarding the benefits of vaccination for pregnant women, hence little is known about vaccines’ efficacy in this population. To determine the maternal-neonatal transplacental transfer of SARS-CoV-2 antibodies among vaccinated parturient women. A control group of COVID-19-recovered patients was included to compare the immunoglobulin G levels between vaccinated and recovered patients. This is a prospective cohort study conducted in a single tertiary medical center in Israel between February and March 2021; parturient women vaccinated with the BNT162b2 messenger RNA vaccine during pregnancy were included and compared with COVID-19-recovered parturient women. SARS-CoV-2 immunoglobulin G antibodies were measured in maternal and cord sera, dried blood spot samples taken from newborns, and breast milk samples. The primary aim was to determine whether neonatal cord and dried blood spot samples were positive for SARS-CoV-2 antibodies and to evaluate the transfer ratio, defined as cord blood immunoglobulin G divided by maternal immunoglobulin G levels. The study included 64 vaccinated parturient women and 11 parturient women who had COVID-19 during pregnancy. All maternal blood sera samples and 98.3% of the cord blood sera samples were positive for SARS-Cov-2 immunoglobulin G with median concentrations of 26.1 (interquartile range, 22.0–39.7) and 20.2 (interquartile range, 12.7–29.0), respectively. Similarly, 96.4% of neonatal blood spot samples and all breast milk samples were positive for SARS-CoV-2 immunoglobulin G with median concentrations of 11.0 (interquartile range, 7.2–12.8) and 4.9 (interquartile range, 3.8–6.0), respectively. There was a significant positive correlation between maternal serum levels of SARS-CoV-2 immunoglobulin G and cord blood (r=0.483; P=.0001), neonatal blood spot (r=0.515; P=.004), and breast milk levels (r=0.396; P=.005) of SARS-CoV-2 immunoglobulin G. The median placental transfer ratio of SARS-COV-2 immunoglobulin G was 0.77. Comparison of vaccinated and recovered COVID-19 patients revealed significantly higher SARS-CoV-2 immunoglobulin G levels in maternal serum and cord blood among vaccinated women (P<.0001). Our study demonstrated the efficient transfer of SARS-CoV-2 immunoglobulin G across the placenta in women, vaccinated with the BNT162b2 messenger RNA vaccine during pregnancy, to their neonates, with a positive correlation between maternal serum and cord blood antibody concentrations. In addition to maternal protection against COVID-19, the vaccine may also provide neonatal humoral immunity.
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DOI：
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影响因子：
15.1
作者：
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DOI：
10.1503/cmaj.202833
发表时间：
2021-03-01
期刊：
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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