Seroprevalence and placental transfer of SARS-CoV-2 antibodies in unvaccinated pregnant women.

Purpose: Pregnant women are at risk of severe SARS-CoV-2 infection, potentially leading to obstetric and neonatal complications. Placental transfer of antibodies directed to SARS-CoV-2 may be protective against neonatal COVID-19, but this remains to be studied. We aimed to determine the seroprevalence of SARS-CoV-2 antibodies in a population of unvaccinated pregnant women and to determine the placental transfer of these antibodies. Methodology: A total of 1197 unvaccinated women with mostly unknown pre-study SARS-CoV-2 infection status, were tested at delivery for SARS-CoV-2 spike protein IgG antibodies during the first year of the pandemic. Umbilical cord samples were collected and assessed for seropositivity if the mother was seropositive. Maternal characteristics, pregnancy and neonatal outcomes and data on SARS-CoV-2 infection were extracted from medical records. Results: Specific IgG were detected in 258 women (21.6%). A significant placental transfer to the newborn was observed in 81.3% of cases. The earlier in the 2nd and 3rd trimesters that the mother had contracted the disease and the more symptomatic she was, the greater the likelihood of transplacental transfer of IgG to her newborn. Conclusion: Approximately one in five women had detectable anti-SARS-CoV-2 spike protein IgG antibodies at delivery during the first year of the pandemic, and these antibodies were significantly transferred to their fetuses. This research provides further evidence to better understand the dynamics of the placental transfer of SARS-CoV-2 IgG antibodies from mothers to their newborns, which is necessary to improve vaccination strategies. Highlights: - In our large cohort of unvaccinated women, almost ten times the size of the largest previously published study, one in five women had detectable anti-SARS-CoV-2 spike protein IgG antibodies at delivery during the first year of the pandemic. - Four out of five women transferred these anti-SARS-CoV-2 spike protein IgG antibodies towards their fetuses. - The earlier the mother was infected—in the 2nd and 3rd trimester—the higher her antibody level, and the more symptomatic she was, the greater the likelihood of transplacental transfer of IgG to her newborn. - As placental transfer is variable and depends on several factors, understanding the dynamics of antibody transfer and its impact on fetal health following a natural SARS-CoV-2 infection, can improve vaccination strategies to optimize neonatal protection. [ABSTRACT FROM AUTHOR]