Level of maternal antibodies against respiratory syncytial virus (RSV) nucleoprotein at birth and risk of RSV very severe lower respiratory tract infection

Abstract

Background: The nucleoprotein (N protein) of respiratory syncytial virus (RSV) is a candidate antigen for new RSV vaccine development. The aim of the present study was to investigate the association between maternal antibody titers against the RSV N protein at birth and the newborns' risk of developing very severe lower respiratory tract infection (VS-LRTI).Methods: In this single-center prospective cohort study, 578 infants born during the RSV epidemic season in France were included. Among these, 36 were hospitalized for RSV VS-LRTI. A generalized linear model was used to test the occurrence of a VS-LRTI in function of sex, mode of delivery, parity of the mother, type of pregnancy, date of birth in relation to the peak of the epidemic, and antibody titer against N protein.Results: All cord blood samples had detectable antibodies against N protein. The mean titers were significantly lower in newborns with risk factors for RSV severe LRTI (preterm infants, birth before the peak epidemic, multiparous mother). There

Maternal Risk Factors for Respiratory Syncytial Virus Lower Respiratory Tract Infection in Otherwise Healthy Preterm and Term Infants: A Systematic Review and Meta-analysis

“…For the secondary analysis, where children of all ages with or without the presence of significant comorbidities were included, an additional 34 studies were identified. 27–60 While most were undertaken in Europe (n = 19) 27–44,59 and North America (n = 6), 45–50 there was representation from Africa/Middle-East (n = 6) 51–54,58,60 and Australasia (n = 3). 55–57 Six focused on preterm, 33,35,40,41,43,46 23 covered both preterm and term 27–32,34,36–39,42,45,47,50–52,54–59 and 5 did not report gestational age.…”

“…27–60 While most were undertaken in Europe (n = 19) 27–44,59 and North America (n = 6), 45–50 there was representation from Africa/Middle-East (n = 6) 51–54,58,60 and Australasia (n = 3). 55–57 Six focused on preterm, 33,35,40,41,43,46 23 covered both preterm and term 27–32,34,36–39,42,45,47,50–52,54–59 and 5 did not report gestational age. 44,48,49,53,60…”

“…In a broader assessment of studies including children of all ages and with or without comorbidities (n = 44, Table, Supplemental Digital Content 4, http://links.lww.com/INF/F550), 19 maternal risk factors were statistically significantly associated with RSV-LRTI/RSVH in multivariate analyses (Table 3). 9–18,27–60 The most commonly reported risk factor was again multiparity [n = 18 (7 preterm, 11 preterm/term)]. 14,17,18,27–29,31–33,36,37,39–41,45,46,55,57 Mother’s ethnicity was the only additional risk factor reported among the preterm studies, which was not identified in the primary analysis.…”

“…9–18,27–60 The most commonly reported risk factor was again multiparity [n = 18 (7 preterm, 11 preterm/term)]. 14,17,18,27–29,31–33,36,37,39–41,45,46,55,57 Mother’s ethnicity was the only additional risk factor reported among the preterm studies, which was not identified in the primary analysis. 33 In the studies involving preterm and term infants, 3 key risk factors linked with increased rates of RSV-LRTI/RSVH were smoking while pregnant (n = 6), 13,31,32,38,39,55 younger (typically <25 years) mothers (n = 6) 18,29,31,32,45,55 and cesarean section (n = 5).…”

“…3,4,[19][20][21][22][23][24][25][26] For the secondary analysis, where children of all ages with or without the presence of significant comorbidities were included, an additional 34 studies were identified. While most were undertaken in Europe (n = 19) [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]59 and North America (n = 6), [45][46][47][48][49][50] there was representation from Africa/Middle-East (n = 6) [51][52][53][54]58,60 and Australasia (n = 3). [55][56][57] Six focused on preterm, 33,35,40,41,43,…”