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

Author:

Cowling Benjamin J1,Perera Ranawaka A P M2,Fang Vicky J1,Chu Daniel K W2,Hui Amelia P W3,Yeung Anita P C4,Peiris J S Malik12,Wong Wilfred H S5,Chan Eunice L Y5,Chiu Susan S5

Affiliation:

1. World Health Organization Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

2. Center of Influenza Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

3. Department of Obstetrics and Gynecology, Queen Mary Hospital, Hong Kong, China

4. Department of Obstetrics and Gynecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

5. Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital and Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

Abstract

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 <10. Conclusions We documented that maternal immunity against influenza B/Yamagata was conferred to infants within the first 6 months of life.

Funder

Research Grants Council of the Hong Kong Special Administration Region

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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