Evaluation of levels of IgG, IgA and anti-SARS-CoV-2 antibodies total in breast milk of women who had COVID-19 during pregnancy

Abstract

Infection with the new coronavirus (COVID-19) in pregnant women is more severe and appears to be greater than in the general population. This infection is associated with a higher risk of premature births, low birth weight, cesarean delivery and admission of newborns (NB) to the neonatal unit. Breastfeeding (BF) decreases the risk of death from infectious diseases and hospitalizations for respiratory diseases. IgA is the immunoglobulin found in greater quantity in human milk and is one of the main factors that protect newborns against infections during breastfeeding. Preliminary studies have described the presence of anti-SARS-CoV - 2 IgA and neutralizing antibodies, recently described in women who had COVID-19 infection during pregnancy and lactation. This study hypothesises that pregnant women contaminated by COVID-19 acquire immunity and transfer the antibodies to their newborns via SCI at the moment of birth until the infant's three months (3m) of life. Objective: To evaluate and describe the levels of IgA, IgG and total anti-SARS-CoV - 2 antibodies in the breast milk of women who had infection with COVID-19 during pregnancy at birth and with 3 months of lactation. Relate the concentrations of IgA and IgG and total anti-SARS-CoV - 2 antibodies in breast milk with (1) Maternal blood levels of IgA and IgG and total anti-SARS-CoV - 2 antibodies, (2) Blood levels in infants of IgA and IgG and total anti-SARS-CoV - 2 antibodies and (3) Time of COVID-19 infection in women. Methods: Prospective cohort study with pregnant women and parturients who presented flu syndrome (SG) proven or probable by COVID-19 and their newborns. The pair will be evaluated at birth and 3 months postpartum. Data collected: health and diseases developed during pregnancy; clinical features and symptoms of COVID-19 infection; gestational age, weight, length and cranial circumference at birth and 3 months old, and complications presented by the infant. Blood samples (5 mL) from the woman and the umbilical cord will be collected at the time of delivery, in addition to 10 mL of colostrum and breast milk at 3 months of lactation to measure IgA, IgG (Kit EUROIMMUN AG, Lüebeck, Germany) and total antibodies (Siemens Kit, USA) anti-SarsCoV-2. (AU)