Transplacental transmission of SARS CoV-2 virus and antibodies in
pregnant women and their new-borns according to the trimester of
maternal infection: A French multicentre prospective study
Abstract
Objective: To quantify the transplacental transmission of SARS-CoV-2 and
antibodies in pregnant women and their new-borns according to the
trimester of maternal infection. Design: This was a prospective
observational multicentre study including pregnant women with positivity
for SARS-CoV-2 by reverse transcription–polymerase chain reaction
(RT‒PCR) or positivity by serology from April to December 2020. The
study was designed to perform a systematic collection of mother/new-born
dyad samples at birth. Setting: Eleven maternity wards in Eastern France
Population: Pregnant women with confirmed COVID-19 infection during
pregnancy and their new-borns. Methods: The SARS-CoV-2 viral load was
measured by RT‒PCR. IgG and IgM antibodies to the receptor-binding
domain of the SARS-CoV-2 spike protein were measured by enzyme-linked
immunosorbent assay. Antibody concentrations and transplacental transfer
ratios were analysed according to the term of maternal infection. Main
Outcome Measure: SARS-CoV-2 viral load in maternal plasma or respiratory
fluids and umbilical cord plasma and quantification of anti-SARS-CoV-2
antibody transfer. Results: Among 165 dyads enrolled, one congenital
infection was confirmed (n=1 (0.63%) IC95% [0.02%; 3.48%]).
Among 165 maternal sera tested, 107 (64.8%) were positive for IgG with
a concentration > 25.6 BAU/ml. The average placental
transfer ratio was 1.27 (95% CI [0.69–2.89]). The transfer ratio
increased with increasing time between the onset of maternal infection
and delivery (P value = 0.0001). Conclusions: We confirmed very low
SARS-CoV-2 transplacental transmission of less than 1%. Transmission of
antibodies is more likely when the infection occurs in the first or
second trimester of pregnancy.