SARS-CoV-2 infection, inflammation and birth outcomes in a prospective NYC pregnancy cohort

Frederieke A.J. Gigase*, Rebecca H. Jessel, Elianna Kaplowitz, Krammer Serology Core Study Group, Natalie Boychuk, Sophie Ohrn, Erona Ibroci, Juliana Castro, Jezelle Lynch, Rushna Tubassum, Amy Balbierz, Nina M. Molenaar, Mara Graziani, Roy Missall, Tammy Flores, Toni Stern, Juan Manuel Carreno, Florian Krammer, Alan Adler, Rachel I. BrodyCorina Lesseur, Jia Chen, Sascha Ellington, Romeo R. Galang, Margaret C. Snead, Elizabeth Howell, Joanne Stone, Veerle Bergink, Siobhan Dolan, Whitney Lieb, Anna Sophie Rommel, Lotje D. de Witte, Teresa Janevic

*Corresponding author for this work

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Abstract

Associations between antenatal SARS-CoV-2 infection and pregnancy outcomes have been conflicting and the role of the immune system is currently unclear. This prospective cohort study investigated the interaction of antenatal SARS-CoV-2 infection, changes in cytokine and HS-CRP levels, birthweight and gestational age at birth. 2352 pregnant participants from New York City (2020–2022) were included. Plasma levels of interleukin (IL)-1β, IL-6, IL-17A and high-sensitivity C-reactive protein (HS-CRP) were quantified in blood specimens obtained across pregnancy. Quantile and linear regression models were conducted to 1) assess the impact of antenatal SARS-CoV-2 infection, overall and by timing of detection of SARS-CoV-2 positivity (< 20 weeks versus ≥ 20 weeks), on birthweight and gestational age at delivery; 2) examine the relationship between SARS-CoV-2 infection and maternal immune changes during pregnancy. All models were adjusted for maternal demographic and obstetric factors and pandemic timing. Birthweight models were additionally adjusted for gestational age at delivery and fetal sex. Immune marker models were also adjusted for gestational age at specimen collection and multiplex assay batch. 371 (15.8%) participants were infected with SARS-CoV-2 during pregnancy, of which 98 (26.4%) were infected at < 20 weeks gestation. Neither SARS-CoV-2 infection in general nor in early or late pregnancy was associated with lower birthweight nor earlier gestational age at delivery. Further, we did not observe cytokine or HS-CRP changes in response to SARS-CoV-2 infection and thus found no evidence to support a potential association between immune dysregulation and the diversity in pregnancy outcomes following infection.

Original languageEnglish
Article number104243
JournalJournal of Reproductive Immunology
Volume163
DOIs
Publication statusPublished - Jun 2024

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