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Immunological assessment of SARS-CoV-2 infection in pregnancy from diagnosis to delivery: a multicentre prospective study

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posted on 2022-03-03, 09:31 authored by Kate Glennon, Jennifer DonnellyJennifer Donnelly, Susan Knowles, Fionnuala M McAuliffe, Alma O’Reilly, Siobhan Corcoran, Jennifer Walsh, Roger McMorrow, Tess Higgins, Lucy Bolger, Susan Clinton, Sarah O’Riordan, Alexander Start, Doireann Roche, Helena BartelsHelena Bartels, Ciara Malone, Karl McAuley, Anthony McDermott, Rosanna Inzitari, Colm P F O'Donnell, Fergal MaloneFergal Malone, Shane Higgins, Cillian De Gascun, Peter Doran, Donal J Brennan

Background: Background Population-based data on SARS-CoV-2 infection in pregnancy and assessment of passive immunity to the neonate, is lacking. We profiled the maternal and fetal response using a combination of viral RNA from naso-pharyngeal swabs and serological assessment of antibodies against SARS-CoV-2.

Methods: This multicentre prospective observational study was conducted between March 24th and August 31st 2020. Two independent cohorts were established, a symptomatic SARS-CoV-2 cohort and a cohort of asymptomatic pregnant women attending two of the largest maternity hospitals in Europe. Symptomatic women were invited to provide a serum sample to assess antibody responses. Asymptomatic pregnant women provided a nasopharyngeal swab and serum sample. RT-PCR for viral RNA was performed using the Cobas SARS-CoV-2 6800 platform (Roche). Umbilical cord bloods were obtained at delivery. Maternal and fetal serological response was measured using both the Elecsys® Anti-SARS-CoV-2 immunoassay (Roche), Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Informed written consent was obtained from all participants.

Results: Ten of twenty three symptomatic women had SARS-CoV-2 RNA detected on nasopharyngeal swabs. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3-5·5%). Nine women had repeat testing post the baseline test. Four (4/9, 44%) remained IgM positive and one remained IgG positive. 3 IgG anti-SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. The mean gestation at serological test was 34 weeks. The mean time between maternal serologic positivity and detection in umbilical cord samples was 28 days.

Conclusion: Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.



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Published Citation

Glennon K. et al. Immunological assessment of SARS-CoV-2 infection in pregnancy from diagnosis to delivery: a multicentre prospective study. PLoS One. 2021;16(9):e0253090

Publication Date

20 September 2021

PubMed ID



  • Obstetrics and Gynaecology
  • School of Medicine


Public Library of Science


  • Published Version (Version of Record)