Skip to main content
Top
Published in:

21-01-2023 | Cyanosis

Impact of the Presence Anti-SARS-CoV-2 IgA in the Colostrum of Women Infected by COVID-19 During the Pregnancy in Neonatal Clinical Outcomes: A Cross-Sectional Study

Authors: Letícia Veríssimo Dutra, Mariliza Henrique Silva, Cibele Wolf Lebrão, Fernando Luiz Affonso-Fonseca, Fabíola Isabel Suano-Souza

Published in: Maternal and Child Health Journal | Issue 4/2023

Login to get access

Abstract

Objectives

To describe the presence of anti-SARS-CoV-2 IgA and IgG in the blood and colostrum of women with COVID-19 infection during pregnancy and associate the presence of anti-SARS-CoV-2 IgA in colostrum with clinical symptoms of their newborns.

Methods

A cross-sectional study was developed with 165 participants with COVID-19 infection during pregnancy and their newborns. Data collected: characteristics COVID-19 infection in pregnant women, gestational age, and clinical symptoms in their newborns (fever, hypothermia, respiratory distress, hypotonia, hypoactivity, hypoglycemia, cyanosis, vomiting/regurgitation, abdominal distention, and jaundice). Maternal blood and colostrum samples were collected postpartum to to detect the presence of IgA and IgG anti-SARS-CoV-2.

Results

The median interval between COVID-19 diagnosis and delivery was 37.5 days (IQ = 12.0, 73.0 days). Clinical symptoms during hospitalization were observed in 55 newborns (33.3%), and two (1.6%) tested RT-PCR positive for COVID-19. Positive colostrum for anti-SARS-CoV-2 IgA was found in 117 (70.9%) women. The presence of anti-SARS-CoV-2 IgA in colostrum was associated independently with lower clinical symptoms in their newborns (OR = 0.42; 95% CI 0.202 to 0.84; p = 0.015).

Conclusions for Practice

The presence of anti-SARS-CoV-2 IgA in colostrum was detected in more than two-thirds of the women evaluated and was associated with a lower frequency of clinical symptoms in their newborns.
Appendix
Available only for authorised users
Literature
go back to reference Bahadur, G., Bhat, M., Acharya, S., Janga, D., Cambell, B., Huirne, J., Yoong, W., Govind, A., Pardo, J., & Homburg, R. (2021). Retrospective observational RT-PCR analyses on 688 babies born to 843 SARS-CoV-2 positive mothers, placental analyses and diagnostic analyses limitations suggest vertical transmission is possible. Facts, Views and Vision in ObGyn, 13(1), 53–66. https://doi.org/10.5254/FVVO.13.1.001CrossRefPubMedPubMedCentral Bahadur, G., Bhat, M., Acharya, S., Janga, D., Cambell, B., Huirne, J., Yoong, W., Govind, A., Pardo, J., & Homburg, R. (2021). Retrospective observational RT-PCR analyses on 688 babies born to 843 SARS-CoV-2 positive mothers, placental analyses and diagnostic analyses limitations suggest vertical transmission is possible. Facts, Views and Vision in ObGyn, 13(1), 53–66. https://​doi.​org/​10.​5254/​FVVO.​13.​1.​001CrossRefPubMedPubMedCentral
go back to reference Benoit, J., Benoit, S. W., Lippi, G., & Henry, B. M. (2020). False negative RT-PCR or false positive serological testing in SARS-CoV-2 diagnostics? Navigating between Scylla and Charybdis to prevent misclassification bias in COVID-19 clinical investigations. Diagnosis (Berlin, Germany), 7(4), 405–407. https://doi.org/10.1515/dx-2020-0091CrossRefPubMed Benoit, J., Benoit, S. W., Lippi, G., & Henry, B. M. (2020). False negative RT-PCR or false positive serological testing in SARS-CoV-2 diagnostics? Navigating between Scylla and Charybdis to prevent misclassification bias in COVID-19 clinical investigations. Diagnosis (Berlin, Germany), 7(4), 405–407. https://​doi.​org/​10.​1515/​dx-2020-0091CrossRefPubMed
go back to reference Civra, A., Francese, R., Donalisio, M., Tonetto, P., Coscia, A., Sottemano, S., Balestrini, R., Faccio, A., Cavallarin, L., Moro, G. E., Bertino, E., & Lembo, D. (2021). Human colostrum and derived extracellular vesicles prevent infection by human rotavirus and respiratory syncytial virus in vitro. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 37(1), 122–134. https://doi.org/10.1177/0890334420988239CrossRefPubMed Civra, A., Francese, R., Donalisio, M., Tonetto, P., Coscia, A., Sottemano, S., Balestrini, R., Faccio, A., Cavallarin, L., Moro, G. E., Bertino, E., & Lembo, D. (2021). Human colostrum and derived extracellular vesicles prevent infection by human rotavirus and respiratory syncytial virus in vitro. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 37(1), 122–134. https://​doi.​org/​10.​1177/​0890334420988239​CrossRefPubMed
go back to reference Demers-Mathieu, V., DaPra, C., Mathijssen, G., Sela, D. A., Järvinen, K. M., Seppo, A., Fels, S., & Medo, E. (2021a). Human milk antibodies against S1 and S2 subunits from SARS-CoV-2, HCoV-OC43, and HCoV-229E in mothers with a confirmed COVID-19 PCR, Viral SYMPTOMS, and unexposed mothers. International Journal of Molecular Sciences, 22(4), 1749. https://doi.org/10.3390/ijms22041749CrossRefPubMedPubMedCentral Demers-Mathieu, V., DaPra, C., Mathijssen, G., Sela, D. A., Järvinen, K. M., Seppo, A., Fels, S., & Medo, E. (2021a). Human milk antibodies against S1 and S2 subunits from SARS-CoV-2, HCoV-OC43, and HCoV-229E in mothers with a confirmed COVID-19 PCR, Viral SYMPTOMS, and unexposed mothers. International Journal of Molecular Sciences, 22(4), 1749. https://​doi.​org/​10.​3390/​ijms22041749CrossRefPubMedPubMedCentral
go back to reference Demers-Mathieu, V., DaPra, C., Mathijssen, G. B., & Medo, E. (2021b). Previous viral symptoms and individual mothers influenced the leveled duration of human milk antibodies cross-reactive to S1 and S2 subunits from SARS-CoV-2, HCoV-229E, and HCoV-OC43. Journal of Perinatology : Official Journal of the California Perinatal Association, 41(5), 952–960. https://doi.org/10.1038/s41372-021-01001-0CrossRefPubMed Demers-Mathieu, V., DaPra, C., Mathijssen, G. B., & Medo, E. (2021b). Previous viral symptoms and individual mothers influenced the leveled duration of human milk antibodies cross-reactive to S1 and S2 subunits from SARS-CoV-2, HCoV-229E, and HCoV-OC43. Journal of Perinatology : Official Journal of the California Perinatal Association, 41(5), 952–960. https://​doi.​org/​10.​1038/​s41372-021-01001-0CrossRefPubMed
go back to reference Duncombe, C. J., McCulloch, D. J., Shuey, K. D., Logue, J. K., Franko, N. M., Wolf, C. R., Frivold, C. J., & Chu, H. Y. (2021). Dynamics of breast milk antibody titer in the six months following SARS-CoV-2 infection. Journal of Clinical Virology: THe Official Publication of the Pan American Society for Clinical Virology, 142, 104916. https://doi.org/10.1016/j.jcv.2021.104916CrossRefPubMed Duncombe, C. J., McCulloch, D. J., Shuey, K. D., Logue, J. K., Franko, N. M., Wolf, C. R., Frivold, C. J., & Chu, H. Y. (2021). Dynamics of breast milk antibody titer in the six months following SARS-CoV-2 infection. Journal of Clinical Virology: THe Official Publication of the Pan American Society for Clinical Virology, 142, 104916. https://​doi.​org/​10.​1016/​j.​jcv.​2021.​104916CrossRefPubMed
go back to reference Elshafeey, F., Magdi, R., Hindi, N., Elshebiny, M., Farrag, N., Mahdy, S., Sabbour, M., Gebril, S., Nasser, M., Kamel, M., Amir, A., Maher Emara, M., & Nabhan, A. (2020). A systematic scoping review of COVID-19 during pregnancy and childbirth. International Journal of Gynaecology and Obstetrics: THe Official Organ of the International Federation of Gynaecology and Obstetrics, 150(1), 47–52. https://doi.org/10.1002/ijgo.13182CrossRefPubMed Elshafeey, F., Magdi, R., Hindi, N., Elshebiny, M., Farrag, N., Mahdy, S., Sabbour, M., Gebril, S., Nasser, M., Kamel, M., Amir, A., Maher Emara, M., & Nabhan, A. (2020). A systematic scoping review of COVID-19 during pregnancy and childbirth. International Journal of Gynaecology and Obstetrics: THe Official Organ of the International Federation of Gynaecology and Obstetrics, 150(1), 47–52. https://​doi.​org/​10.​1002/​ijgo.​13182CrossRefPubMed
go back to reference Giuliani, F., Oros, D., Gunier, R. B., Deantoni, S., Rauch, S., Casale, R., Nieto, R., Bertino, E., Rego, A., Menis, C., Gravett, M. G., Candiani, M., Deruelle, P., García-May, P. K., Mhatre, M., Ado Usman, M., Abd-Elsalam, S., Etuk, S., Napolitano, R., ... Villar, J. (2022). Effects of prenatal exposure to maternal COVID-19 and perinatal care on neonatal outcome: results from the INTERCOVID Multinational cohort study. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2022.04.019CrossRefPubMedPubMedCentral Giuliani, F., Oros, D., Gunier, R. B., Deantoni, S., Rauch, S., Casale, R., Nieto, R., Bertino, E., Rego, A., Menis, C., Gravett, M. G., Candiani, M., Deruelle, P., García-May, P. K., Mhatre, M., Ado Usman, M., Abd-Elsalam, S., Etuk, S., Napolitano, R., ... Villar, J. (2022). Effects of prenatal exposure to maternal COVID-19 and perinatal care on neonatal outcome: results from the INTERCOVID Multinational cohort study. American Journal of Obstetrics and Gynecology. https://​doi.​org/​10.​1016/​j.​ajog.​2022.​04.​019CrossRefPubMedPubMedCentral
go back to reference Gonçalves-Ferri, W. A., Pereira-Cellini, F. M., Coca, K., Aragon, D. C., Nader, P., Lyra, J. C., do Vale, M. S., Marba, S., Araujo, K., Dias, L. A., de Lima Mota Ferreira, D. M., Nieto, G., Anchieta, L. M., de Cássia Silveira, R., de Moura, M., Tuma Calil, V., Moraes, V., de Almeida, J., Magalhães, M., … BRACOVID Project Collaborative Group. (2021). The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study. International Breastfeeding Journal, 16(1), 30. https://doi.org/10.1186/s13006-021-00377-1CrossRefPubMedPubMedCentral Gonçalves-Ferri, W. A., Pereira-Cellini, F. M., Coca, K., Aragon, D. C., Nader, P., Lyra, J. C., do Vale, M. S., Marba, S., Araujo, K., Dias, L. A., de Lima Mota Ferreira, D. M., Nieto, G., Anchieta, L. M., de Cássia Silveira, R., de Moura, M., Tuma Calil, V., Moraes, V., de Almeida, J., Magalhães, M., … BRACOVID Project Collaborative Group. (2021). The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study. International Breastfeeding Journal, 16(1), 30. https://​doi.​org/​10.​1186/​s13006-021-00377-1CrossRefPubMedPubMedCentral
go back to reference Juncker, H. G., Romijn, M., Loth, V. N., Ruhé, E., Bakker, S., Kleinendorst, S., de Groot, C., Pajkrt, D., Korosi, A., van Goudoever, J. B., van Gils, M. J., & van Keulen, B. J. (2021). Antibodies against SARS-CoV-2 in human milk: Milk conversion rates in the Netherlands. Journal of Human Lactation: Official Journal of International Lactation Consultant Association. https://doi.org/10.1177/08903344211018185CrossRefPubMed Juncker, H. G., Romijn, M., Loth, V. N., Ruhé, E., Bakker, S., Kleinendorst, S., de Groot, C., Pajkrt, D., Korosi, A., van Goudoever, J. B., van Gils, M. J., & van Keulen, B. J. (2021). Antibodies against SARS-CoV-2 in human milk: Milk conversion rates in the Netherlands. Journal of Human Lactation: Official Journal of International Lactation Consultant Association. https://​doi.​org/​10.​1177/​0890334421101818​5CrossRefPubMed
go back to reference Lebrão, C. W., Cruz, M. N., Silva, M., Dutra, L. V., Cristiani, C., Affonso Fonseca, F. L., & Suano-Souza, F. I. (2020). Early identification of IgA Anti-SARSCoV-2 in milk of mother with COVID-19 infection. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 36(4), 609–613. https://doi.org/10.1177/0890334420960433CrossRefPubMed Lebrão, C. W., Cruz, M. N., Silva, M., Dutra, L. V., Cristiani, C., Affonso Fonseca, F. L., & Suano-Souza, F. I. (2020). Early identification of IgA Anti-SARSCoV-2 in milk of mother with COVID-19 infection. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 36(4), 609–613. https://​doi.​org/​10.​1177/​0890334420960433​CrossRefPubMed
go back to reference Narayanaswamy, V., Pentecost, B., Alfandari, D., Chin, E., Minor, K., Kastrinakis, A., Lieberman, T., Arcaro, K. F., … Leftwich, H. (2021). Humoral and cell-mediated immune response in colostrum from women diagnosed positive for SARS-CoV-2. Breastfeeding Medicine : THe Official Journal of the Academy of Breastfeeding Medicine, 16(12), 987–994. https://doi.org/10.1089/bfm.2021.0082CrossRefPubMed Narayanaswamy, V., Pentecost, B., Alfandari, D., Chin, E., Minor, K., Kastrinakis, A., Lieberman, T., Arcaro, K. F., … Leftwich, H. (2021). Humoral and cell-mediated immune response in colostrum from women diagnosed positive for SARS-CoV-2. Breastfeeding Medicine : THe Official Journal of the Academy of Breastfeeding Medicine, 16(12), 987–994. https://​doi.​org/​10.​1089/​bfm.​2021.​0082CrossRefPubMed
go back to reference Nascimento, A. S., Sant’Anna, D., Fonseca, D. J., Monçores, E., Matos, G., Rossetto, I., Petrucceli, J. L., Beltrão, K. I., Athias, L., Paixão, M., Teixeira, M. P., Osorio, R. G., & Sugahara, S. (2013). Características Étnico-raciais da População: Classificações e identidades. Instituto Brasileiro de Geografia e Estatística, IBGE. Nascimento, A. S., Sant’Anna, D., Fonseca, D. J., Monçores, E., Matos, G., Rossetto, I., Petrucceli, J. L., Beltrão, K. I., Athias, L., Paixão, M., Teixeira, M. P., Osorio, R. G., & Sugahara, S. (2013). Características Étnico-raciais da População: Classificações e identidades. Instituto Brasileiro de Geografia e Estatística, IBGE.
go back to reference Pace, R. M., Williams, J. E., Järvinen, K. M., Meehan, C. L., Martin, M. A., Ley, S. H., Barbosa-Leiker, C., Andres, A., Yeruva, L., Belfort, M. B., Caffé, B., Navarrete, A. D., Lackey, K. A., Pace, C., Gogel, A. C., Fehrenkamp, B. D., Klein, M., Young, B. E., Rosen-Carole, C., … Seppo, A. E. (2021). Milk from women diagnosed with COVID-19 does not contain SARS-CoV-2 RNA but has persistent levels of SARS-CoV-2-specific IgA antibodies. Frontiers in Immunology, 12, 801797. https://doi.org/10.3389/fimmu.2021.801797CrossRefPubMedPubMedCentral Pace, R. M., Williams, J. E., Järvinen, K. M., Meehan, C. L., Martin, M. A., Ley, S. H., Barbosa-Leiker, C., Andres, A., Yeruva, L., Belfort, M. B., Caffé, B., Navarrete, A. D., Lackey, K. A., Pace, C., Gogel, A. C., Fehrenkamp, B. D., Klein, M., Young, B. E., Rosen-Carole, C., … Seppo, A. E. (2021). Milk from women diagnosed with COVID-19 does not contain SARS-CoV-2 RNA but has persistent levels of SARS-CoV-2-specific IgA antibodies. Frontiers in Immunology, 12, 801797. https://​doi.​org/​10.​3389/​fimmu.​2021.​801797CrossRefPubMedPubMedCentral
go back to reference Papageorghiou, A. T., Ohuma, E. O., Altman, D. G., Todros, T., Cheikh Ismail, L., Lambert, A., Jaffer, Y. A., Bertino, E., Gravett, M. G., Purwar, M., Noble, J. A., Pang, R., Pietrasanta, C., Darwich, A., Ronchi, A., Crippa, B., Spada, E., Mosca, F., Pugni, L., & Rescigno, M. (2022). Humoral response to anti-SARS-CoV-2 vaccine in breastfeeding mothers and mother-to-infant antibody transfer through breast milk. NPJ Vaccines, 7(1), 63. https://doi.org/10.1038/s41541-022-00499-5CrossRef Papageorghiou, A. T., Ohuma, E. O., Altman, D. G., Todros, T., Cheikh Ismail, L., Lambert, A., Jaffer, Y. A., Bertino, E., Gravett, M. G., Purwar, M., Noble, J. A., Pang, R., Pietrasanta, C., Darwich, A., Ronchi, A., Crippa, B., Spada, E., Mosca, F., Pugni, L., & Rescigno, M. (2022). Humoral response to anti-SARS-CoV-2 vaccine in breastfeeding mothers and mother-to-infant antibody transfer through breast milk. NPJ Vaccines, 7(1), 63. https://​doi.​org/​10.​1038/​s41541-022-00499-5CrossRef
go back to reference Sevilla-Montoya, R., Hidalgo-Bravo, A., Estrada-Gutiérrez, G., Villavicencio-Carrisoza, O., Leon-Juarez, M., Villegas-Mota, I., Espino-Y-Sosa, S., Monroy-Muñoz, I. E., Martínez-Portilla, R., Poon, L., Cardona-Pérez, J. A., Helguera-Repetto, A. C., Collaborators. (2021). Evidence of possible vertical SARS-CoV-2 transmission according to the World Health Organization criteria in asymptomatic pregnant women. Ultrasound in Obstetrics & Gynecology. https://doi.org/10.1002/uog.24787CrossRef Sevilla-Montoya, R., Hidalgo-Bravo, A., Estrada-Gutiérrez, G., Villavicencio-Carrisoza, O., Leon-Juarez, M., Villegas-Mota, I., Espino-Y-Sosa, S., Monroy-Muñoz, I. E., Martínez-Portilla, R., Poon, L., Cardona-Pérez, J. A., Helguera-Repetto, A. C., Collaborators. (2021). Evidence of possible vertical SARS-CoV-2 transmission according to the World Health Organization criteria in asymptomatic pregnant women. Ultrasound in Obstetrics & Gynecology. https://​doi.​org/​10.​1002/​uog.​24787CrossRef
go back to reference Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C., Lancet Breastfeeding Series Group. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet (London, England), 387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7CrossRefPubMed Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C., Lancet Breastfeeding Series Group. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet (London, England), 387(10017), 475–490. https://​doi.​org/​10.​1016/​S0140-6736(15)01024-7CrossRefPubMed
go back to reference Villar, J., Ariff, S., Gunier, R. B., Thiruvengadam, R., Rauch, S., Kholin, A., Roggero, P., Prefumo, F., de Vale, M. S., Cardona-Perez, J. A., Maiz, N., Cetin, I., Savasi, V., Deruelle, P., Easter, S. R., Sichitiu, J., Soto Conti, C. P., Ernawati, E., Mhatre, M., … Papageorghiou, A. T. (2021). Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID multinational cohort study. JAMA Pediatrics, 175(8), 817–826. https://doi.org/10.1001/jamapediatrics.2021.1050CrossRefPubMed Villar, J., Ariff, S., Gunier, R. B., Thiruvengadam, R., Rauch, S., Kholin, A., Roggero, P., Prefumo, F., de Vale, M. S., Cardona-Perez, J. A., Maiz, N., Cetin, I., Savasi, V., Deruelle, P., Easter, S. R., Sichitiu, J., Soto Conti, C. P., Ernawati, E., Mhatre, M., … Papageorghiou, A. T. (2021). Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: The INTERCOVID multinational cohort study. JAMA Pediatrics, 175(8), 817–826. https://​doi.​org/​10.​1001/​jamapediatrics.​2021.​1050CrossRefPubMed
go back to reference Wang, Z., Lorenzi, J., Muecksch, F., Finkin, S., Viant, C., Gaebler, C., Cipolla, M., Hoffmann, H. H., Oliveira, T. Y., Oren, D. A., Ramos, V., Nogueira, L., Michailidis, E., Robbiani, D. F., Gazumyan, A., Rice, C. M., Hatziioannou, T., Bieniasz, P. D., Caskey, M., & Nussenzweig, M. C. (2021). Enhanced SARS-CoV-2 neutralization by dimeric IgA. Science Translational Medicine, 13(577), eabf155. https://doi.org/10.1126/scitranslmed.abf1555CrossRef Wang, Z., Lorenzi, J., Muecksch, F., Finkin, S., Viant, C., Gaebler, C., Cipolla, M., Hoffmann, H. H., Oliveira, T. Y., Oren, D. A., Ramos, V., Nogueira, L., Michailidis, E., Robbiani, D. F., Gazumyan, A., Rice, C. M., Hatziioannou, T., Bieniasz, P. D., Caskey, M., & Nussenzweig, M. C. (2021). Enhanced SARS-CoV-2 neutralization by dimeric IgA. Science Translational Medicine, 13(577), eabf155. https://​doi.​org/​10.​1126/​scitranslmed.​abf1555CrossRef
Metadata
Title
Impact of the Presence Anti-SARS-CoV-2 IgA in the Colostrum of Women Infected by COVID-19 During the Pregnancy in Neonatal Clinical Outcomes: A Cross-Sectional Study
Authors
Letícia Veríssimo Dutra
Mariliza Henrique Silva
Cibele Wolf Lebrão
Fernando Luiz Affonso-Fonseca
Fabíola Isabel Suano-Souza
Publication date
21-01-2023
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 4/2023
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-022-03553-9

Keynote webinar | Spotlight on adolescent vaping

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Watch now
Video