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Neonatal SARS-CoV-2 immunoglobulin G antibodies at delivery and their impact on COVID-19

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Abstract

Objective

To assess neonatal SARS-CoV-2 anti-spike IgG antibody levels after maternal mRNA COVID-19 vaccination and/or infection during pregnancy and evaluate their protective effect.

Methods

Prospective observational study, conducted from January 2021 to December 2022. Infants were tested for anti-spike IgG antibodies at birth and then every 3 months until disappearance of titer. A follow-up was done for SARS-CoV-2 infection up to 12 months.

Results

In total, 147 newborns were enrolled with a median (IQR) gestational age of 39.60 weeks (38.3–40.4). Median (IQR) titers in UA/ml at 2 days were higher (P < .001) in newborns of vaccinated 7063.7 (2841.4–14,448.1), than of infected mothers 372.7 (158.00–884.90). Titers dropped significantly during the follow-up but 50% still had a detectable titer at 6 months. A high antibody titer at 2 days led to a longer persistence (HR 0.89, IC 95% 0.83–0.96, P = .004). In total, 36 infants were infected during the first months of life coinciding with the Omicron variant. Fifty percent had detectable antibodies during the infection period. Relationship between high IgG titers and month of infection was inverse (RHO − 0.52, P = .009).

Conclusion

Though a high antibody titer at birth led to longer persistence, no protective effect against infection was found. As newborns are a high risk group for COVID-19, avoiding transmission during the first year of life is important.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to their containing information that could compromise the privacy of research participants, but are available from the corresponding author on reasonable request.

Code availability

N/A.

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Acknowledgements

Thank you to Gerard Laracy for his extensive effort and commitment to the editing and proofreading of this manuscript. Thank you to Aina Millan from the platform of support in Methodology and Statistics of the IdISBa. And also thank you to all the participating families.

Author information

Authors and Affiliations

  1. Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain

    Susanne Vetter-Laracy, Victoria Jimenez, Marina Roldán, Marta Bernardino & Pere Balliu-Badia

  2. Balearic Islands Health Research Institute (IdISBa), Palma, Spain

    Susanne Vetter-Laracy, Victoria Jimenez, Marta Bernardino, Pere Balliu-Badia & Francisco Fanjul

  3. Department of Microbiology, University Hospital Son Espases, Palma, Spain

    Paula Lara, Ricardo Manuel Arcay & Pablo Fraile-Ribot

  4. Department of Gynecology and Obstetrics, University Hospital Son Espases, Palma, Spain

    Maria Vila

  5. Department of Internal Medicine, University Hospital Son Espases, Palma, Spain

    Francisco Fanjul

Authors
  1. Susanne Vetter-Laracy
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  2. Victoria Jimenez
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Contributions

Drs Vetter-Laracy, Jimenez, and Roldán conceptualized and designed the study, coordinated and supervised data collection, carried out the initial analysis and interpretation of data collection, drafted the initial manuscript, and approved the final manuscript as submitted.

Drs Lara, Arcay, and Fraile provided all microbiological test results and helped in coordinating and supervising the data collection, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Drs Balliu, Fanjul, and Vila did substantial contributions to conception and design, reviewed and revised the manuscript, and approved the final manuscript as submitted.

All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Susanne Vetter-Laracy.

Ethics declarations

Ethics approval

In case of accepting their inclusion in the study, after having received verbal and written information about the study, informed consent was signed (consent for maternal data and as representative for the newborn). The study was approved by the Ethic Committee for Research of the Balearic Island with number CEI: IB 4551/21 PI.

Consent to participate

In case of accepting their inclusion in the study, after having received verbal and written information about the study, informed consent was signed (consent for maternal data and as representative for the newborn).

Consent to publish data

The mothers of participating children agreed to participate together with their newborns in the study and to publish the data. No individual data where participants could be identified, i.e., images, were published.

Conflict of interest

The authors declare no competing interests.

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Article summary

This study is contributing to the understanding of durability and effectiveness of infants passively obtained immunity against SARS-CoV-2. Incidence of infection was not lower among infants with high antibody titers during the Omicron period, though the symptoms of COVID-19 were mild.

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Vetter-Laracy, S., Jimenez, V., Roldán, M. et al. Neonatal SARS-CoV-2 immunoglobulin G antibodies at delivery and their impact on COVID-19. Eur J Clin Microbiol Infect Dis 43, 693–702 (2024). https://doi.org/10.1007/s10096-024-04773-3

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  • DOI: https://doi.org/10.1007/s10096-024-04773-3

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