Maternal Antibodies Against Influenza in Cord Blood and Protection Against Laboratory-Confirmed Influenza in Infants

Abstract Background Studies that correlate maternal antibodies with protection from influenza A or B virus infection in young infants in areas with prolonged influenza circulation are lacking. Methods We conducted a prospective, observational study to evaluate the effects of maternally transferred a...

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Bibliographic Details
Published in:Clinical infectious diseases 2020-10, Vol.71 (7), p.1741-1748
Main Authors: Cowling, Benjamin J, Perera, Ranawaka A P M, Fang, Vicky J, Chu, Daniel K W, Hui, Amelia P W, Yeung, Anita P C, Peiris, J S Malik, Wong, Wilfred H S, Chan, Eunice L Y, Chiu, Susan S
Format: Article
Language:English
Subjects:
Antibodies, Viral
Female
Fetal Blood
Hemagglutination Inhibition Tests
Humans
Infant
Influenza A Virus, H1N1 Subtype
Influenza A Virus, H3N2 Subtype
Influenza B virus
Influenza Vaccines
Influenza, Human - prevention & control
Laboratories
Pregnancy
Prospective Studies
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Summary:Abstract Background Studies that correlate maternal antibodies with protection from influenza A or B virus infection in young infants in areas with prolonged influenza circulation are lacking. Methods We conducted a prospective, observational study to evaluate the effects of maternally transferred antibodies against influenza A and B viruses against laboratory-confirmed influenza in a cohort born over 24 months. Cord blood samples were retrieved at birth and infants were actively followed for the first 6 months of life. Nasal swabs were collected and tested for influenza A and B by reverse transcriptase–polymerase chain reaction whenever an illness episode was identified. Cord blood samples were tested by the hemagglutination inhibition (HAI) assay to viruses that circulated during the follow-up period. Results 1162 infants were born to 1140 recruited women: 1092 (94%) infants completed 6 months of follow-up. Proportions of cord blood with HAI antibody titers ≥40 against A(H1N1), A(H3N2), B/Victoria, and B/Yamagata were 31%, 24%, 31%, and 54%, respectively. Only 4% of women had maternal influenza vaccination. Cord blood antigen-specific HAI titers ≥40 were found to correlate with protection from infection only for influenza B/Yamagata. No influenza B virus infection occurred in infants ≤60 days old. Proportional hazards analysis showed that a cord blood HAI titer of 40 was associated with 83% (95% confidence interval, 44–95%) reduction in the risk of influenza B/Yamagata infections compared with a cord blood titer
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciz1058