Differences in antibody levels between participants with previous COVID-19 exposure and those without were expressed as a fold switch difference between median antibody levels for each group, with standard deviations (SDs) expressed as a fold change based on the median of the group with previous COVID-19 exposure and group without COVID-19 exposure. samples and 101 maternal and cord blood pairs were analyzed. Of notice, 37 patients experienced a known history of COVID-19 (positive polymerase chain reaction test) during pregnancy. Of 36 patients, 16 (44%) were diagnosed with COVID-19 within 7 days of delivery. Moreover, 15 of the remaining 76 patients (20%) without a known diagnosis experienced positive maternal serology. For those with a history of COVID-19, we identified strong immunoglobulin G response in maternal blood to CoV-2 nucleocapsid, spike (full length), and spike (receptor-binding domain name) antigens with more modest responses to the spike (N-terminal domain name) antigen. In contrast, the maternal blood immunoglobulin M response seemed more specific to spike (full length) epitopes than nucleocapsid, spike (receptor-binding domain name), or spike (N-terminal domain name) epitopes. There were significantly higher maternal and cord blood immunoglobulin G responses not only to CoV-2 spike (127.1-fold; cis-Pralsetinib standard deviation, cis-Pralsetinib 2.0; test, categorical with Pearson chi-square analysis. Differences in antibody levels between participants with previous COVID-19 exposure and those without were expressed as a fold switch difference between median antibody levels for each group, with standard deviations (SDs) expressed as a fold change based on the median of the group with previous COVID-19 exposure and group without COVID-19 exposure. The correlation between factors was assessed with bivariate correlation and reported with Pearson correlation coefficient (r). Comparisons of paired maternal and cord blood serology were carried out using linear regression to determine the slope, correlation coefficient, and R2. The relationship between latency (>7 or <7 days) and antibody titers was evaluated with simple binary logistic regression. A value of <.05 was considered significant for all those analyses. The figures were generated using the packages in R. Results During the study period, there were 112 maternal samples, including 101 maternal and cord blood pairs collected. Of notice, 36 patients experienced a known history of COVID-19 (positive PCR test) in the pregnancy. Of the 36 patients, 16 (44%) were diagnosed with COVID-19 within 7 days of delivery. Moreover, 15 of the remaining 76 patients without a known diagnosis experienced a positive maternal serology (IgG or IgM to SARS-CoV-2 spike); this was reflected in positive cord blood IgG as well. This represented a 20% seroprevalence rate among study participants. Baseline characteristics Baseline characteristics are explained in Table 1 . There were Rabbit polyclonal to PRKCH 51 in the group with COVID-19 (40 with maternal and cord blood paired samples available). Black and Hispanic patients were disproportionately represented in the group with COVID-19. The severity of COVID-19 illness and symptoms was documented for 32 of 36 known cases with most patients (n=30) being asymptomatic or having moderate severity of illness and 2 having moderate severity of illness. Table 1 Comparison of baseline characteristics and pregnancy outcomes in pregnant women with and without polymerase chain reaction or serologic evidence of COVID-19 valuevalue
Pregnancy characteristicsRace.41White, non-Hispanic14 (52)9 (36)Black, non-Hispanic8 (30)9 (36)Asian1 (4)0 (0)Hispanic4 (15)7 (28)Previous full-term delivery13 (48)15 (60).39Previous preterm birth3 (11)1 (4).34Chronic hypertension7 (36)4 (16).38Pregestational diabetes mellitus0 (0)1 (4).48Preeclampsia or gestational hypertension10 (37)7 (28).49Placental pathologyPlacenta unremarkable6 (22)1 (4).10Aadorable inflammatory pathology7 (26)9 (36).43Chronic inflammatory pathology1 (4)0 (0).33Maternal vascular malperfusion8 (30)14 (56).05Fetal vascular malperfusion1 (4)0 (0).33Intervillous thrombus3 (11)3 (12).92 Open in a separate windows Data are presented as number (percentage), unless otherwise indicated. PCR, polymerase chain reaction Boelig. Serologic profile of maternal and cord blood SARS-CoV-2 antibodies. Am J Obstet Gynecol Glob Rep 2022. Open in a separate window Physique 5 Maternal SARS CoV-2 antibody titers and placental pathology Data were taken from 22 patients with maternal vascular malperfusion documented on placental histopathology and 30 patients with no evidence of maternal vascular malperfusion. Data are reported as natural log-transformed luminescence transmission. Mean maternal nucleoprotein (N)-IgM and spike (S)-IgM were significantly higher in patients with maternal vascular malperfusion (10.31.5 vs 9.60.8 [P=.03] and 10.02.0 vs 8.81.9 [P=.02], respectively), as were N-IgG and S-IgG (10.62.7 vs 9.1 2.0 [P=.02] and 10.42.9 vs 8.32.4 [P=.01], respectively). CI, cis-Pralsetinib confidence interval; IgG, immunoglobulin G; IgM, immunoglobulin M. Boelig. Serologic profile of maternal and cord blood SARS-CoV-2 antibodies. Am J Obstet Gynecol Glob Rep cis-Pralsetinib 2022. Conversation Principal findings There was highly efficient transfer in maternal to cord blood IgG, with IgG response to nucleocapsid and spike and IgM to spike (full length) showing the highest specificity. IgG antibodies were cross-reactive with related CoV-1 and MERS spike epitopes, whereas IgM antibodies, which largely do not cross the placenta, were highly SARS-CoV-2 specific. Our results suggested that (1) both nucleocapsid and full-length spike IgG and.