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Passive and active immunity in infants born to mothers with SARS-CoV-2 infection during pregnancy: prospective cohort study

Por: Song · D. · Prahl · M. · Gaw · S. L. · Narasimhan · S. R. · Rai · D. S. · Huang · A. · Flores · C. V. · Lin · C. Y. · Jigmeddagva · U. · Wu · A. · Warrier · L. · Levan · J. · Nguyen · C. B. T. · Callaway · P. · Farrington · L. · Acevedo · G. R. · Gonzalez · V. J. · Vaaben · A. · Nguyen · P.

To investigate maternal immunoglobulins’ (IgM, IgG) response to SARS-CoV-2 infection during pregnancy and IgG transplacental transfer, to characterise neonatal antibody response to SARS-CoV-2 infection, and to longitudinally follow actively and passively acquired antibodies in infants.


A prospective observational study.


Public healthcare system in Santa Clara County (California, USA).


Women with symptomatic or asymptomatic SARS-CoV-2 infection during pregnancy and their infants were enrolled between 15 April 2020 and 31 March 2021.


SARS-CoV-2 serology analyses in the cord and maternal blood at delivery and longitudinally in infant blood between birth and 28 weeks of life.


Of 145 mothers who tested positive for SARS-CoV-2 during pregnancy, 86 had symptomatic infections: 78 with mild-moderate symptoms, and 8 with severe-critical symptoms. The seropositivity rates of the mothers at delivery was 65% (95% CI 0.56% to 0.73%) and the cord blood was 58% (95% CI 0.49% to 0.66%). IgG levels significantly correlated between the maternal and cord blood (Rs=0.93, p


Maternal SARS-CoV-2 IgG is efficiently transferred across the placenta when infections occur more than 2 months before delivery. Maternally derived passive immunity may persist in infants up to 6 months of life. Neonates are capable of mounting a strong antibody response to perinatal SARS-CoV-2 infection.