1
|
Kugelman N, Nahshon C, Shaked-Mishan P, Cohen N, Lahav Sher M, Barsha H, Shalabna E, Zolotarevsky A, Lavie O, Kedar R, Riskin-Mashiah S. Third trimester messenger RNA COVID-19 booster vaccination upsurge maternal and neonatal SARS-CoV-2 immunoglobulin G antibody levels at birth. Eur J Obstet Gynecol Reprod Biol 2022; 274:148-154. [PMID: 35653903 PMCID: PMC9148860 DOI: 10.1016/j.ejogrb.2022.05.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE BNT162b2 messenger RNA (mRNA) COVID-19 vaccine administered during pregnancy was found to produce a strong maternal immunoglobulin (IgG) response which crosses the placenta to the newborn. Our aim was to evaluate maternal and neonatal SARS-CoV-2 IgG antibody levels at birth, following a COVID-19 booster vaccine during the third trimester. STUDY DESIGN A prospective cohort study including women admitted to delivery ward at least 7 days after their BNT162b2 (Pfizer/BioNTech) booster vaccination without a prior clinical COVID-19 infection. SARS-CoV-2 IgG antibodies levels were measured in maternal blood upon admission to delivery and in the umbilical blood within 30 min following delivery. The correlation between antibody titers, feto-maternal characteristics, maternal side effects following vaccination, and time interval from vaccination to delivery were analyzed. RESULTS Between September to November 2021, high antibody levels were measured in all 102 women and 93 neonatal blood samples, at a mean ± standard deviation duration of 7.0 ± 2.9 weeks after the third vaccine. We found positive correlation between maternal and neonatal antibodies (r = 0.73, 95% confidence interval [CI] 0.61 to 0.81, p < 0.001), with neonatal titers approximately 1.4 times higher compared to maternal titers. In the multivariable analysis maternal antibody levels dropped by -7.2% (95% CI -12.0 to -2.3%, p = 0.005) for each week that passed since the receipt of the third vaccine dose. In contrary, systemic side effects after the third vaccine were associated with higher maternal antibody levels of 52.0% (95% CI 4.7 to 120.8%, p = 0.028). Also, for each 1 unit increase in maternal body mass index, maternal antibody levels increased by 3.6% (95% CI 0.4 to 6.9%, p = 0.025). CONCLUSIONS BNT162b2 mRNA COVID-19 booster dose during the third trimester of pregnancy was associated with strong maternal and neonatal responses as reflected by maternal and neonatal SARS-CoV-2 IgG antibody levels measured at birth. These findings support the administration of the COVID-19 booster to pregnant women to restore maternal and neonatal protection during the ongoing pandemic.
Collapse
Affiliation(s)
- Nir Kugelman
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel,Corresponding author at: Department of Obstetrics and Gynecology, Carmel Medical Center, 7 Michal St., Haifa 3436212, Israel
| | - Chen Nahshon
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Nadav Cohen
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Maayan Lahav Sher
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hanin Barsha
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Eiman Shalabna
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Avi Zolotarevsky
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ofer Lavie
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Reuven Kedar
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shlomit Riskin-Mashiah
- Department of Obstetrics & Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
2
|
Kugelman N, Nahshon C, Shaked-Mishan P, Cohen N, Sher ML, Gruber M, Marom I, Zolotarevsky A, Lavie O, Damti A, Zilberlicht A, Bardicef M, Kedar R. Maternal and Neonatal SARS-CoV-2 Immunoglobulin G Antibody Levels at Delivery After Receipt of the BNT162b2 Messenger RNA COVID-19 Vaccine During the Second Trimester of Pregnancy. JAMA Pediatr 2022; 176:290-295. [PMID: 34932066 PMCID: PMC8693209 DOI: 10.1001/jamapediatrics.2021.5683] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE BNT162b2 messenger RNA (mRNA) COVID-19 vaccination in the third trimester was found to be associated with a strong maternal humoral IgG response that crossed the placenta and approached maternal titers in the newborn. OBJECTIVE To evaluate maternal and neonatal SARS-CoV-2 immunoglobulin G (IgG) antibody levels at birth after mRNA COVID-19 vaccination during the second trimester of pregnancy. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study, conducted at a single medical center in Haifa, Israel, from May to July 2021, included women with a singleton pregnancy over 24 weeks of gestation at least 7 days after receipt of their second COVID-19 vaccine dose who were not known to be previously infected with COVID-19. EXPOSURES BNT162b2 (Pfizer/BioNTech) vaccination. MAIN OUTCOMES AND MEASURES The primary outcomes were SARS-CoV-2 IgG antibody titers measured in the parturient at admission and in the umbilical cord blood within 30 minutes after delivery. Secondary outcomes were the correlation between antibody titers, feto-maternal characteristics, maternal adverse effects after vaccination, and time interval from vaccination to delivery. RESULTS Antibody levels were measured for 129 women (mean [SD] age, 31.9 [4.9] years) and 114 neonates, with 100% of the tests having positive results. The mean (SD) gestational age at administration of the second vaccine dose was 24.9 (3.3) weeks. Neonatal IgG titers were 2.6 times higher than maternal titers (median [range], 3315.7 [350.1-17 643.5] AU/mL vs 1185.2 [146.6-32 415.1] AU/mL). A positive correlation was demonstrated between maternal and neonatal antibodies (r = 0.92; 95% CI, 0.89-0.94). Multivariable analysis revealed that for each week that passed since receipt of the second vaccine dose, maternal and neonatal antibody levels changed by -10.9% (95% CI, -17.2% to -4.2%; P = .002) and -11.7% (95% CI, -19.0 to -3.8%; P = .005), respectively. For each 1-year increase in the mother's age, maternal and neonatal antibody levels changed by -3.1% (95% CI, -5.3% to -0.9%; P = .007) and -2.7% (95% CI, -5.2% to -0.1%; P = .04), respectively. CONCLUSIONS AND RELEVANCE In this cohort study, receipt of the BNT162b2 mRNA COVID-19 vaccine during the second trimester of pregnancy was associated with maternal and neonatal humoral responses, as reflected in maternal and neonatal SARS-CoV-2 IgG antibody levels measured after delivery. These findings support COVID-19 vaccination of pregnant individuals during the second trimester to achieve maternal protection and newborn safety during the pandemic.
Collapse
Affiliation(s)
- Nir Kugelman
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Chen Nahshon
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Nadav Cohen
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Maayan Lahav Sher
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Maya Gruber
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Inbal Marom
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Avi Zolotarevsky
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ofer Lavie
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amit Damti
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ariel Zilberlicht
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Mordehai Bardicef
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Reuven Kedar
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|