Abstract
Background: Coronavirus disease 2019 (COVID-19) during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies.
Methods: Maternal and cord blood sera were collected from mother-newborn dyads (n = 402), following term delivery after antenatal 2-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected.
Results: Median anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following first-trimester vaccination (n = 90; anti-S IgG: 76 AU/mL; anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the second trimester (n = 124; anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1263 AU/mL), and highest after third-trimester vaccination (n = 188; anti-S IgG: 240 AU/mL; anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the first trimester (anti-S IgG: 126 AU/mL; anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the first trimester (n = 30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels.
Conclusions: These results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose hints at its potential benefit in those who completed the 2-dose vaccine series at early pregnancy or before conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.
Keywords: COVID-19; SARS-CoV-2; pregnancy; serology; vaccination.
【저자키워드】 COVID-19, SARS-CoV-2, serology, vaccination., Pregnancy, 【초록키워드】 mRNA vaccination, Coronavirus disease 2019, Vaccine, coronavirus, vaccination, antibody, immunization, Receptor binding domain, vaccine dose, Maternal, sera, SARS-CoV-2 spike protein, Vaccination strategies, age, Care, booster dose, Blood, antibody level, antibody waning, severe disease, Neonatal, antibody transfer, Antenatal, acute respiratory syndrome, infancy, anti-S, parturient, implication, benefit, lowest, highest, collected, evaluated, significantly higher, early gestation, Evaluating, IgG level, SARS-CoV-2 BNT162b2, 【제목키워드】 coronavirus 2, Maternal, respiratory, BNT162b2 mRNA, Effect, Level,