loading page

Immunological assessment of SARS-CoV-2 Infection in Pregnancy From Diagnosis to Delivery: A multicentre prospective observational study
  • +22
  • Kate Glennon,
  • Jennifer Donnelly,
  • Susan Knowles,
  • Fionnuala McAuliffe,
  • Alma O Reilly,
  • Siobhan Corcoran,
  • Jennifer Walsh,
  • Roger McMorrow,
  • Tess Higgins,
  • Lucy Bolger,
  • Susan Clinton,
  • Sarah O Riordan,
  • Alex Start,
  • Doireann Roche,
  • Helena Bartels,
  • Ciara Malone,
  • Karl McAuley,
  • Anthony Mc Dermott,
  • Rosanna Inzitari,
  • Colm P.F. O Donnell,
  • Fergal Malone,
  • Shane Higgins,
  • Cillian De Gascun,
  • Peter Doran,
  • Donal Brennan
Kate Glennon
University College Dublin

Corresponding Author:kate.glennon@ucd.ie

Author Profile
Jennifer Donnelly
RCSI School of Medicine
Author Profile
Susan Knowles
National Maternity Hospital
Author Profile
Fionnuala McAuliffe
UCD Perinatal Research Centre
Author Profile
Alma O Reilly
RCSI School of Medicine
Author Profile
Siobhan Corcoran
National Maternity Hospital
Author Profile
Jennifer Walsh
National Maternity Hospital
Author Profile
Roger McMorrow
National Maternity Hospital
Author Profile
Tess Higgins
National Maternity Hospital
Author Profile
Lucy Bolger
National Maternity Hospital
Author Profile
Susan Clinton
National Maternity Hospital
Author Profile
Sarah O Riordan
National Maternity Hospital
Author Profile
Alex Start
UCD Perinatal Research Centre
Author Profile
Doireann Roche
National Maternity Hospital
Author Profile
Helena Bartels
Rotunda Hospital
Author Profile
Ciara Malone
Rotunda Hospital
Author Profile
Karl McAuley
Clinical Research Centre, UCD School of Medicine
Author Profile
Anthony Mc Dermott
Clinical Research Centre, UCD School of Medicine
Author Profile
Rosanna Inzitari
Clinical Research Centre, UCD School of Medicine
Author Profile
Colm P.F. O Donnell
Neonatal Unit, UCD School of Medicine
Author Profile
Fergal Malone
RCSI School of Medicine
Author Profile
Shane Higgins
National Maternity Hospital
Author Profile
Cillian De Gascun
National Virus Reference Laboratory
Author Profile
Peter Doran
Clinical Research Centre, UCD School of Medicine
Author Profile
Donal Brennan
University College Dublin
Author Profile

Abstract

Objective We profile the maternal and fetal response to SARS-CoV-2 infection in symptomatic and asymptomatic pregnant women and make an assessment of passive immunity to the neonate, Design Multicentre prospective study. Setting Dublin, Ireland Methods RT-PCR for viral RNA via a nasopharyngeal swab was performed using the Cobas SARS-CoV-2 6800 platform. Maternal, and fetal serological antibody response, via umbilical cord bloods, was measured using both the Elecsys® immunoassay, Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Main outcome Measure Prevalence of RT PCR positive SARS-CoV-2. Assessment of IgM and IgG anti-SARS-CoV-2 serology antibodies. Results Ten of twenty three symptomatic women had SARS-CoV-2 RNA in a nasopharyngeal swab. 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 between post baseline. Four (4/9, 44%) remained IgM positive, one IgG positive. IgG anti SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. 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-CoV-2. 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.