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One of the many big questions scientists are trying to answer is whether people who contract Covid-19 during pregnancy will impart natural immunity to their newborns.
Recent studies have hinted that they might. And new findings, published in the journal JAMA Pediatrics on Friday, provide another piece of the puzzle, offering more evidence that Covid-19 antibodies can cross the placenta.
“What we found is pretty consistent with what we’ve learned from studies of other viruses,” said Scott E. Hensley, associate professor of microbiology at the Perelman School of Medicine at the University of Pennsylvania and the one of the main authors of the study.
Moreover, he added, the study suggests that women not only transfer antibodies to their fetuses, but also transfer more antibodies to their babies if they are infected earlier in their pregnancy. This could have implications for when women should be vaccinated against Covid-19, Dr Hensley said, adding that vaccinating women earlier in pregnancy might offer more protective benefits, “but studies actually analyzing the vaccination in pregnant women must be completed. “
In the study, researchers from Pennsylvania tested more than 1,500 women who gave birth at the Pennsylvania Hospital in Philadelphia between April and August of last year. Of these, 83 women were found to have Covid-19 antibodies – and after giving birth, 72 of these babies tested positive for Covid-19 antibodies via their cord blood, whether their mothers had symptoms or not.
According to Dr. Karen Puopolo, associate professor of pediatrics at the University of Pennsylvania and one of the study’s lead authors, about half of these babies had antibody levels as high or higher than those found in the blood from their mother, and in about a quarter of cases the levels of antibodies in the umbilical cord blood were 1.5 to 2 times higher than the levels in the mother.
“It’s pretty effective,” Dr Puopolo said.
The researchers also observed that the longer the period of time between the onset of a pregnant woman’s Covid-19 infection and her delivery, the more antibodies transferred, a finding that has been noted elsewhere.
The antibodies that crossed the placenta were immunoglobulin G, or IgG, antibodies of the type that are made within days of becoming infected and are believed to offer long-term protection against the coronavirus.
None of the babies in this study had immunoglobulin M or IgM antibodies, which are usually not detected until soon after infection, suggesting that the babies had not been infected with the coronavirus.
Experts do not yet know whether the amount of antibodies given to babies was enough to prevent newborns from contracting Covid-19. And because only a few of the babies in the study were born prematurely, the researchers can’t tell if babies who were born early might lack these protective antibodies. The study authors also noted that because their results came from a single facility, the results would need to be replicated further.
The placenta is a complex organ and one that has been under-studied, said Dr. Denise Jamieson, an obstetrician at Emory University in Atlanta and a member of the American College of Obstetricians and Gynecologists Covid Expert Panel, who does was not involved in the study.
And more research is needed to better understand whether the antibodies generated by the vaccine behave in a comparable manner to antibodies to Covid-19 infection, said Dr Andrea G. Edlow, assistant professor of obstetrics, gynecology and health. reproductive biology at Harvard Medical School.
In a study published in the journal Cell in December, for example, Dr. Edlow and her colleagues found that Covid-19 antibodies from a natural infection could cross the placenta less efficiently than antibodies produced after the flu vaccination and whooping cough (whooping cough). .
“What we really want to know is that the antibodies in the vaccine effectively cross the placenta and protect the baby, as we know what happens in influenza and whooping cough,” Dr Jamieson said.
Experts are unsure whether the Covid vaccine will work this way, in part because pregnant women were excluded from initial clinical trials.
“It is plausible that the Covid vaccine offers protection to both pregnant women and their infants,” said Dr Mark Turrentine, member of the COGG Covid Expert Panel. “For me,” he added, “this study highlights that the inclusion of pregnant women participating in clinical trials such as the Covid-19 vaccine is essential, especially when the benefit of vaccination is greater than potential risk of life-threatening illness. “
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