Association of Gestational Age at COVID-19 Vaccination, History of SARS-CoV-2 Infection, and a Vaccine Booster With Maternal and Umbilical Cord Antibody Levels at Delivery
TAKE-HOME MESSAGE
- This retrospective cohort study examined maternal and umbilical cord blood anti-spike IgG levels at delivery in patients who received COVID-19 vaccination before and during pregnancy and the association of prior SARS-CoV-2 infection and vaccine booster with anti-spike maternal and umbilical cord IgG levels. Maternal anti-spike IgG levels were detectable at delivery regardless of vaccination timing, and early third trimester vaccination was associated with the highest anti-spike IgG levels in maternal and umbilical cord blood. Women with prior infection who were vaccinated in the first trimester had similar anti-spike IgG levels to those without prior infection who were vaccinated in the third trimester. A booster dose in the third trimester was associated with anti-spike IgG levels greater than that of third trimester vaccination in women with or without prior infection.
- Complete vaccination against COVID-19, prior SARS-CoV-2 infection, and third trimester booster vaccination are associated with the highest levels of maternal and umbilical cord antibodies.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVE
To describe maternal and umbilical cord blood anti-spike immunoglobulin (Ig)G levels at delivery with coronavirus disease 2019 (COVID-19) vaccination before and during pregnancy and to assess the association of prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a vaccine booster dose with anti-spike maternal and umbilical cord IgG levels.
METHODS
We conducted a retrospective cohort study of women with self-reported COVID-19 vaccination (Pfizer-BioNTech, Moderna, or Johnson & Johnson/Janssen), including a booster dose, during or before pregnancy, who delivered at 34 weeks of gestation or more. Maternal and umbilical cord blood samples at delivery were analyzed for semi-quantitative anti-spike IgG. We examined the association between timing of maternal vaccination and maternal and umbilical cord anti-spike levels using a rank sum test. The relationships between a prior history of SARS-CoV-2 infection and maternal and umbilical cord anti-spike IgG levels, and between a booster dose and maternal and umbilical cord anti-spike levels, were also evaluated using a rank sum test.
RESULTS
We included data from 1,359 vaccinated pregnant women, including 20 women who received a booster dose, and 1,362 umbilical cord samples. Maternal anti-spike IgG levels were detectable at delivery regardless of timing of vaccination throughout pregnancy among fully vaccinated women; however, early third-trimester vaccination was associated with the highest anti-spike IgG levels in maternal and umbilical cord blood. Among women with a history of SARS-CoV-2 infection, maternal and cord blood antibody response achieved with vaccination in early pregnancy was comparable with third-trimester vaccination in pregnant women without a history of SARS-CoV-2 infection. A booster dose in the third trimester was associated with maternal anti-spike IgG levels greater than third-trimester vaccination in women with or without a history of SARS-CoV-2 infection.
DISCUSSION
Vaccination against COVID-19 before and throughout pregnancy was associated with detectable maternal anti-spike IgG levels at delivery. A complete vaccination course, prior history of SARS-CoV-2 infection, and a third-trimester booster dose were associated with the highest maternal and umbilical cord antibody levels.
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Additional Info
Association of Gestational Age at Coronavirus Disease 2019 (COVID-19) Vaccination, History of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, and a Vaccine Booster Dose With Maternal and Umbilical Cord Antibody Levels at Delivery
Obstet Gynecol 2022 Mar 01;139(3)373-380, YJ Yang, EA Murphy, S Singh, AC Sukhu, I Wolfe, S Adurty, D Eng, J Yee, I Mohammed, Z Zhao, LE Riley, M PrabhuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.