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Background <p>Newborns depend on the transfer of IgG across the placenta to acquire protection against pathogens. We assessed the placental transfer of SARS-CoV-2 antibodies, primarily derived from infection, from seropositive pregnant women enrolled in a pregnancy cohort in Kilifi, Kenya.</p> Methods <p>The study was nested within a prospective observational multi-country cohort study. All available paired maternal delivery and cord blood samples were selected. Maternal sera were tested for SARS-CoV-2 receptor binding domain (RBD) IgM/IgG total antibodies using the Wantai assay. For positive samples, maternal and corresponding cord blood samples were tested for SARS-CoV-2 IgG antibodies against the spike (anti-spike) and nucleocapsid proteins (anti-NCP) using ELISA kits from Euroimmun.</p> Results <p>A total of 492 (56.1%) out of 877 maternal delivery samples were positive for RBD IgM/IgG total antibodies. Of these, 416 (84.6%) were seropositive for either anti-NCP IgG, anti-spike IgG antibodies or both. A total of 412 out of 496 (83%) cord blood samples tested positive for either anti-NCP or anti-spike antibodies. The geometric mean ratio was 1.04 (95% CI: 0.90, 1.21), indicating no significant difference between the anti-spike IgG concentration in cord and maternal blood samples. The log-transformed maternal and cord blood anti-spike IgG concentrations showed a weak positive correlation (<i>r</i> = 0.364,&#xa0;<i>n</i> = 496,&#xa0;<i>p</i> &lt; 0.001). No maternal or neonatal factors were associated with the anti-spike IgG placental transfer ratio.</p> Conclusion <p>Placental transfer of SARS-CoV-2 antibodies was evident in a population of pregnant women whose immunity was primarily derived from infection given the low SARS-CoV-2 vaccine coverage in the study area. The positive correlation between maternal and cord blood anti-spike concentrations suggests that interventions that increase maternal antibody concentrations such as vaccination may increase passive immunity and protection against severe COVID-19 disease in neonates.</p>

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Placental transfer of SARS-CoV-2 antibodies in mother-neonate pairs: a prospective nested cohort study

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  • 发表日期：

    2025年7月1日

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  • Alex G. Mugo,
  • Angela Koech,
  • Liberty Cantrell,
  • Moses Mukhanya,
  • Isaac Mwaniki,
  • Joseph Mutunga,
  • Merryn Voysey,
  • Rachel Craik,
  • Peter von Dadelszen,
  • Kirsty Le Doare,
  • Marleen Temmerman,
  • Geoffrey Omuse,
  • Bridget Freyne,
  • Kondwani Kawaza,
  • Samantha Lissauer,
  • Kalvor Sommerfelt,
  • Melani Etti,
  • Robert Mboizi,
  • Stephen Cose,
  • Victoria Nankabirwa,
  • Lauren Hookham,
  • Joseph Ouma,
  • Gordon Rukondo,
  • Madeleine Cochet,
  • Patricia Okiro,
  • Onesmus Wanje,
  • Consolata Juma,
  • Charlotte Ndana,
  • Douglas Nyankira,
  • Tindi Otieno,
  • Rose Chebet,
  • Winfred Muithi,
  • Washingtone Owino,
  • Quinter Okello,
  • Michael Ochieng,
  • Margaret Wachira,
  • Kelvin Mbote,
  • Mercy Osele,
  • John Kibwanga,
  • Happy Mdigo,
  • Claire Ngure,
  • Joy Wanja,
  • Claire Kiti,
  • Winnie Nzoka,
  • Grace Anyange,
  • Robin Okello,
  • David Mwadziwe,
  • Ruth Mambo,
  • Sarah Maitha,
  • Juma Gumbo,
  • Jamal Salim,
  • Mary Kalido,
  • Salim Mwakanyenze,
  • Anne Mutua,
  • Asha Tunje,
  • Noveline Khatievi,
  • Nathan Barreh,
  • Belinder Orero,
  • Mwanajuma Khamisi,
  • Eric Mataza,
  • Said Lele,
  • Olivia Kasuu,
  • Susan Sidi,
  • Hassan Kopa,
  • Faith Pola,
  • Umberto D’Alessandro,
  • Anna Roca,
  • Hawanatu Jah,
  • Andrew Prentice,
  • Melisa Martinez-Alvarez,
  • Brahima Diallo,
  • Abdul Sesay,
  • Sambou Suso,
  • Yahaya Idris,
  • Baboucarr Njie,
  • Fatima Touray,
  • Fatoumata Kongira,
  • Modou F. S. Ndure,
  • Gibril Gabbidon,
  • Lawrence Gibba,
  • Abdoulie Bah,
  • Yorro Bah,
  • Esperança Sevene,
  • Anifa Vala,
  • Sonia Maculuve,
  • Corssino Tchavana,
  • Helena Boene,
  • Lazaro Quimice,
  • Salesio Macuacua,
  • Carla Carrilho,
  • Laura A. Magee,
  • Marie-Laure Volvert,
  • Thomas Mendy,
  • Donna Russell,
  • Prestige Tatenda Makanga,
  • Liberty Makacha,
  • Reason Mlambo,
  • Lucilla Poston,
  • Rachel Tribe,
  • Sophie Moore,
  • Tatiana Salisbury,
  • Aris Papageorghiou,
  • Alison Noble,
  • Hannah Blencowe,
  • Veronique Filippi,
  • Joy Lawn,
  • Matt Silver,
  • Joseph Akuze,
  • Ursula Gazeley,
  • Judith Cartwright,
  • Guy Whitley,
  • Sanjeev Krishna,
  • Marianne Vidler,
  • Jing Larry Li,
  • Jeff Bone,
  • Mai-Lei Maggie Woo Kinshella,
  • Domena Tu,
  • Ash Sandhu,
  • Kelly Pickerill,
  • Carla Carillho,
  • Benjamin Barratt

摘要

Background

Newborns depend on the transfer of IgG across the placenta to acquire protection against pathogens. We assessed the placental transfer of SARS-CoV-2 antibodies, primarily derived from infection, from seropositive pregnant women enrolled in a pregnancy cohort in Kilifi, Kenya.

Methods

The study was nested within a prospective observational multi-country cohort study. All available paired maternal delivery and cord blood samples were selected. Maternal sera were tested for SARS-CoV-2 receptor binding domain (RBD) IgM/IgG total antibodies using the Wantai assay. For positive samples, maternal and corresponding cord blood samples were tested for SARS-CoV-2 IgG antibodies against the spike (anti-spike) and nucleocapsid proteins (anti-NCP) using ELISA kits from Euroimmun.

Results

A total of 492 (56.1%) out of 877 maternal delivery samples were positive for RBD IgM/IgG total antibodies. Of these, 416 (84.6%) were seropositive for either anti-NCP IgG, anti-spike IgG antibodies or both. A total of 412 out of 496 (83%) cord blood samples tested positive for either anti-NCP or anti-spike antibodies. The geometric mean ratio was 1.04 (95% CI: 0.90, 1.21), indicating no significant difference between the anti-spike IgG concentration in cord and maternal blood samples. The log-transformed maternal and cord blood anti-spike IgG concentrations showed a weak positive correlation (r = 0.364, n = 496, p < 0.001). No maternal or neonatal factors were associated with the anti-spike IgG placental transfer ratio.

Conclusion

Placental transfer of SARS-CoV-2 antibodies was evident in a population of pregnant women whose immunity was primarily derived from infection given the low SARS-CoV-2 vaccine coverage in the study area. The positive correlation between maternal and cord blood anti-spike concentrations suggests that interventions that increase maternal antibody concentrations such as vaccination may increase passive immunity and protection against severe COVID-19 disease in neonates.