Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), ranges from asymptomatic to severe infection. We aimed to compare the prevalence of COVID‐19 in asymptomatic pregnant versus nonpregnant women in order to establish recommendations for a COVID‐19 screening strategy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349848

Should pregnant women be screened for SARS‐CoV‐2 infection? A prospective multicenter cohort study

Immune changes that occur during pregnancy may place pregnant women at an increased risk for severe disease following viral infections like SARS-CoV-2. Whether these immunologic changes modify the immune response to SARS-CoV-2 infection during pregnancy is not well understood.This study aimed to compare the humoral immune response to SARS-CoV-2 infection in pregnant and nonpregnant women. The immune response following vaccination for SARS-CoV-2 was also explored.In this cohort study, 24 serum samples from 20 patients infected with SARS-CoV-2 during pregnancy were matched by number of days after a positive test with 46 samples from 40 nonpregnant women of reproductive age. Samples from 9 patients who were vaccinated during pregnancy were also examined. Immunoglobulin G and immunoglobulin M levels were measured. Trends in the log antibody levels over time and mean antibody levels were assessed using generalized estimating equations.The median number of days from first positive test to sampling was 6.5 in the pregnant group (range, 3-97) and 6.0 among nonpregnant participants (range, 2-97). No significant differences in demographic or sampling characteristics were noted between the groups. No differences in immunoglobulin G or immunoglobulin M levels over time or mean antibody levels were noted among pregnant and nonpregnant participants following SARS-CoV-2 infection for any of the SARS-CoV-2 antigen targets examined (spike, spike receptor-binding domain, spike N-terminal domain, and nucleocapsid). Participants who were vaccinated during pregnancy had higher immunoglobulin G levels than pregnant patients who tested positive for all SARS-CoV-2 targets except nucleocapsid antibodies (all P<.001) and had lower immunoglobulin M spike (P<.05) and receptor-binding domain (P<.01) antibody levels.This study suggests that the humoral response following SARS-CoV-2 infection does not seem to differ between pregnant women and their nonpregnant counterparts. These findings should reassure patients and healthcare providers that pregnant patients seem to mount a nondifferential immune response to SARS-CoV-2. 

https://doi.org/10.1016/j.xagr.2023.100192

Humoral immune response to SARS-CoV-2 in pregnant and nonpregnant women following infection

Background: The recent novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) pandemic has been responsible for millions of deaths globally. Several vaccines against the SARS-CoV-2 virus have been developed. Objective: To estimate the proportion of newborns who acquire IgG anti-SARS-CoV-2 antibodies from mothers vaccinated against COVID-19. Methods: Eligible study subjects seeking care in the Obstetrics & Gynecology department for delivery were recruited in this cross-sectional analytic study. Demographic and clinical characteristics of the study subjects were noted and around 3–5 mL venous blood was collected from each study participant duo (mother and newborn) to detect IgG antibodies to SARS-CoV2 “S” protein. Results: Over the entire study period, 125 pregnant ladies who were vaccinated with two doses of any COVID-19 vaccine were included in the study. A sizeable proportion (44.0%) of vaccinated pregnant women were seropositive for IgG antibodies to SARS-CoV2 “S” protein. A significantly high number of seropositive newborns (82.8%) were delivered to seropositive mothers as compared to seronegative mothers (OR 41.1; 95% confidence interval 14.6–116.1, p < .0001). Conclusions: The present study reveals that a substantial proportion of newborns acquired SARS-CoV-2 antibodies from their vaccinated seropositive mothers through transplacental transfer.

SARS CoV-2 Antibodies in Cord Blood of Neonates Delivered to Pregnant Mothers Vaccinated for COVID-19

BACKGROUND: Background Population-based data on SARS-CoV-2 infection in pregnancy and assessment of passive immunity to the neonate, is lacking. We profiled the maternal and fetal response using a combination of viral RNA from naso-pharyngeal swabs and serological assessment of antibodies against SARS-CoV-2. METHODS: This multicentre prospective observational study was conducted between March 24th and August 31st 2020. Two independent cohorts were established, a symptomatic SARS-CoV-2 cohort and a cohort of asymptomatic pregnant women attending two of the largest maternity hospitals in Europe. Symptomatic women were invited to provide a serum sample to assess antibody responses. Asymptomatic pregnant women provided a nasopharyngeal swab and serum sample. RT-PCR for viral RNA was performed using the Cobas SARS-CoV-2 6800 platform (Roche). Umbilical cord bloods were obtained at delivery. Maternal and fetal serological response was measured using both the Elecsys® Anti-SARS-CoV-2 immunoassay (Roche), Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Informed written consent was obtained from all participants. RESULTS: Ten of twenty three symptomatic women had SARS-CoV-2 RNA detected on nasopharyngeal swabs. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3-5·5%). Nine women had repeat testing post the baseline test. Four (4/9, 44%) remained IgM positive and one remained IgG positive. 3 IgG anti-SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. The mean gestation at serological test was 34 weeks. The mean time between maternal serologic positivity and detection in umbilical cord samples was 28 days. CONCLUSION: Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.

/pdf/immunological-assessment-of-sars-cov-2-infection-in-1h8axsi7sj.pdf

Immunological assessment of SARS-CoV-2 infection in pregnancy from diagnosis to delivery: A multicentre prospective study.

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Immunological assessment of SARS-CoV-2 infection in pregnancy from diagnosis to delivery: A multicentre prospective study.