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SARS-CoV-2 neutralizing antibody titers in maternal blood, umbilical cord blood, and breast milk

Journal of Perinatology volume 44, pages 28–34 (2024)Cite this article

Subjects

Abstract

Objective

We quantified neutralizing SARS-CoV-2 antibody against spike protein (nAb) levels after vaccination and SARS-CoV-2 infection in maternal serum, cord blood, and breast milk and determined whether they correlate with levels of spike protein binding antibody.

Study design

Women (n = 100) were enrolled on admission for delivery. Previous SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies. Levels of nAb and binding antibodies against spike receptor binding domain were measured in maternal blood, cord blood, and milk.

Results

Maternal nAb levels were higher after vaccine and infection than vaccine alone but waned rapidly. Levels of nAb in cord blood and milk correlated with maternal levels and were higher in cord blood than maternal. Spike protein binding antibody levels correlated with nAb.

Conclusion

SARS-CoV-2 vaccination near delivery may boost antibody-mediated immunity in the peripartum period. Neutralizing antibodies are passed transplacentally and into milk. Spike protein binding antibody may be a feasible proxy for nAb.

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Fig. 1: ln(Neutralizing Ab levels) versus number of days from last exposure by exposure group.
Fig. 2: Relationship of spike antigen binding antibody levels with neutralizing antibody levels.

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Data availability

The datasets generated and analyzed during this study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Division of Neonatology and Newborn Medicine, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA

    Mazen Khalifeh, Karen Skinner & Mona Maloney

  2. Division of Pediatric Infectious Diseases, Cohen Children’s Medical Center, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA

    Lorry G. Rubin

  3. Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital, Northwell Health, Sleepy Hollow, NY, USA

    David Dayya

  4. Biostatistics Unit, Office of Academic Affairs, Northwell School, New Hyde Park, NY, USA

    Jane Cerise

  5. Labcorp-Monogram Biosciences, South San Francisco, CA, 94080, USA

    Charles Walworth, Christos J. Petropoulos & Terri Wrin

  6. Labcorp-Esoterix, Calabasas, CA, 91301, USA

    Kelly Chun

  7. Division of Neonatal-Perinatal Medicine, Cohen Children’s Medical Center, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA

    Barry Weinberger

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  1. Mazen Khalifeh
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Contributions

MK, LR, JC, BW: study design, data analysis, writing manuscript DD: data analysis, writing manuscript KS, MM: data collection, reviewing manuscript CW, CJP, TW, KC: study design, sample analysis, reviewing manuscript.

Corresponding author

Correspondence to Barry Weinberger.

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Khalifeh, M., Rubin, L.G., Dayya, D. et al. SARS-CoV-2 neutralizing antibody titers in maternal blood, umbilical cord blood, and breast milk. J Perinatol 44, 28–34 (2024). https://doi.org/10.1038/s41372-023-01843-w

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