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BJOG . Trends in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and vaccine antibody prevalence in a multi-ethnic inner-city

tetano

Editor, Senior Moderator
BJOG


. 2023 Apr 27.
doi: 10.1111/1471-0528.17508. Online ahead of print. Trends in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and vaccine antibody prevalence in a multi-ethnic inner-city antenatal population: A cross-sectional surveillance study

Daria Andreeva[SUP] 1 [/SUP], Carolyn Gill[SUP] 1 [/SUP], Anna Brockbank[SUP] 1 [/SUP], Joanna Hejmej[SUP] 1 [/SUP], Fran Conti-Ramsden[SUP] 1 [/SUP], Katie J Doores[SUP] 2 [/SUP], Paul T Seed[SUP] 1 [/SUP], Lucilla Poston[SUP] 1 [/SUP]; eLIXIR Partnership



Collaborators, Affiliations
Abstract

Objective: To determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in pregnancy in an inner-city setting and assess associations with demographic factors and vaccination timing.
Design: Repeated cross-sectional surveillance study.
Setting: London maternity centre.
Sample: A total of 906 pregnant women attending nuchal scans, July 2020-January 2022.
Methods: Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported vaccination status and coronavirus disease 2019 (COVID-19) infection were recorded. Multivariable regression models determined demographic factors associated with seroprevalence and antibody titres.
Main outcome measures: Immunoglobulin G N- and S-protein antibody titres.
Results: Of the 960 women, 196 (20.4%) were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Among unvaccinated women, women of black ethnic backgrounds were most likely to be SARS-CoV-2 seropositive (versus white adjusted risk ratio [aRR] 1.88, 95% CI 1.35-2.61, p < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (versus white aRR 0.58, 95% CI 0.40-0.84, p = 0.004; aRR 0.56, 95% CI 0.34-0.92, p = 0.021, respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titres than unvaccinated, previously infected women (mean difference 4.76 fold-change, 95% CI 2.65-6.86, p < 0.001). Vaccination timing before versus during pregnancy did not affect IgG S-antibody titres (mean difference -0.28 fold-change, 95% CI -2.61 to 2.04, p = 0.785).
Conclusions: This cross-sectional study demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnic backgrounds having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titres were highest among double-vaccinated, infected women.

Keywords: early pregnancy; infectious disease: virology; maternity services; medical disorders in pregnancy.

 
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