279 - Cord Blood Examination In Women With SARS-CoV2 Exposure And/Or Vaccination During Pregnancy And Relationship To Cortisol, Ferritin, CBC, Vitamin D, And CRP At Birth

Poster Number: 279
Publication Number: 279.226

Garrett Muckleroy, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Eric T. Mendenhall, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Cynthia Massey, Marshall University Joan C. Edwards School of Medicine, Scott Depot, WV, United States; Jordan Needens, Marshall OBGYN, Huntington, WV, United States; Mary Beth Hogan, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Meagan W. Shepherd, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Ashlee Roybal, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Dustin Miller, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Nidhi Shekar, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Rebecca C. Barnett, Marshall University Joan C. Edwards School of Medicine, Hurricane, WV, United States; Christopher L. Damron, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Jodi Plumley, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Hisham A. Keblawi, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Caleb Huff, St Marys Medical, Hurricane, WV, United States; Jesse Cottrell, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Kristin Sinning, Marshall University, Huntington, WV, United States; Katherine Addicott, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Adam H. Young, Marshall Health, Huntington, WV, United States; Nana A. Bosomtwe, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Hayley Weese, Marshall University Joan C. Edwards School of Medicine, Lavalette, WV, United States; Anisha Valluri, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Matthew Nudelman, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Deborah L. Preston, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States; Jessica Haas, Hoops Family Children's Hospital, Huntington, WV, United States; Balaji Govindaswami, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, United States

Background: The transplacental transfer of maternal antibodies during gestation may offer neonatal immunological protection. Maternal SARS-CoV2 exposure in pregnancy may alter fetal-placental inflammatory and/or stress response.

Objective: 1.Measure total and SARS-CoV2-specific antibodies (IgG, IgM, IgA) in cord blood of infants born to women with documented SARS-CoV2 exposure and/or vaccination in pregnancy compared to unvaccinated women with no history of documented exposure and test negative prior to delivery2.Measure cortisol, ferritin, CBC, vitamin D, and CRP in cord blood at birth

Design/Methods: This study seeks to include 100 mothers with documented SARS-CoV2 exposure and/or vaccination in pregnancy. Patients were recruited from May 2021 to present. Maternal and neonatal demographics and clinical variables were obtained from chart review. 6-10 cc of cord blood were obtained in the first few minutes after placental delivery. A portion of cord blood was sent to Cincinnati Children’s nephrology lab for analysis of SARS-CoV2-specific antibodies. The remainder was analyzed at Cabell Huntington Hospital. Total and SARS-CoV2-specific IgA was obtained to exclude possibility of maternal blood contamination. Simple univariable regression has been performed while multivariable analysis awaits complete data collection.

Results: 84 of the target 100 mothers for cord blood collection are enrolled. Current analysis is of 72 patients divided into 4 groups based on SARS-CoV2 exposure/vaccination and presence of neonatal SARS-CoV2-specific IgG. Table 1 contains analysis of maternal characteristics. Compared to controls, mothers with a history of SARS-CoV2 exposure or disease were more likely to be in rural areas (12% vs. 42%). Table 2 shows infant metrics and cord blood analysis. Ferritin and cortisol were elevated in mothers with history of SARS-CoV2 exposure or disease with respect to control, but only in cord blood samples without SARS-CoV2-specific IgG. Normal biological variation occurred in the CBC, CRP, and vitamin D.Conclusion(s): Rural pregnant mothers had greater risk of SARS-CoV2 exposure or disease. There was no evidence of fetal SARS-CoV2-specific IgM in cord blood. Vaccination resulted in a consistently larger level of SARS-CoV2-specific IgG in cord blood than native infection. Vaccination with SARS-CoV2 exposure/disease resulted in the highest prevalence of SARS-CoV2-specific IgG titers above 1:12800. Ferritin and cortisol were found to be elevated in cord blood samples of women with a history of SARS-CoV2 exposure or disease, but only those with no SARS-CoV2-specific IgG. Multivariable regression is pending.
Table 1Maternal Characteristics and SARS-CoV2 Vaccination/Exposure Status
Table 2Infant Characteristics and Cord Blood Results at Birth