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Trends in SARS-CoV-2 Infection and Vaccine Antibody Prevalence in a Multi-Ethnic Inner-City Antenatal Population: a Cohort Study
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  • Daria Andreeva,
  • Carolyn Gill,
  • Anna Brockbank,
  • Joanna Hejmej,
  • Fran Conti-Ramsden,
  • Katie Doores,
  • Paul Seed,
  • Lucilla Poston
Daria Andreeva
King's College London

Corresponding Author:[email protected]

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Carolyn Gill
King's College London
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Anna Brockbank
King's College London
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Joanna Hejmej
King's College London
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Fran Conti-Ramsden
King's College London
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Katie Doores
King's College London
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Paul Seed
King's College London
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Lucilla Poston
King's College London
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Abstract

Objective: To determine SARS-CoV-2 seroprevalence in a UK pregnancy cohort and assess associations with demographic factors and vaccination timing. Design: Observational cohort study. Setting: UK inner-city maternity centre. Sample: 960 pregnant women attending nuchal scans from July 2020-January 2022. Methods: Blood samples were tested for IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins. Self-reported demographics, vaccination status and previous Covid-19 infection were extracted from health records. Multivariable regression models determined factors associated with seroprevalence and antibody titers. Main outcome measures: IgG N- and S-protein antibody titers. Results: 196/960 (20.4%) women were SARS-CoV-2 seropositive from previous infection. Of these, 70 (35.7%) self-reported previous infection. Amongst unvaccinated women, black women were most likely to be SARS-CoV-2 seropositive (aRR 1.88 [95% CI, 1.35-2.61], P < 0.001). Women from black and mixed ethnic backgrounds were least likely to have a history of vaccination with seropositivity to S-protein (aRR 0.58 [95% CI, 0.40-0.84], P = 0.004 and aRR 0.56 [95% CI, 0.34-0.92], P = 0.021 respectively). Double vaccinated, previously infected women had higher IgG S-protein antibody titers than unvaccinated, previously infected women (mean difference: 4.76, 95% CI = [2.65, 6.86], P < 0.001). Vaccination timing before vs during pregnancy did not significantly affect IgG S antibody titers (F(1, 77) = [0.07], P = 0.785). Conclusions: This inner-city pregnancy cohort demonstrates high rates of asymptomatic SARS-CoV-2 infection with women of black ethnicity having higher infection risk and lower vaccine uptake. SARS-CoV-2 antibody titers were highest among double vaccinated, previously infected women.
09 Oct 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 Oct 2022Submission Checks Completed
12 Oct 2022Assigned to Editor
12 Oct 2022Review(s) Completed, Editorial Evaluation Pending
24 Oct 2022Reviewer(s) Assigned
30 Nov 2022Editorial Decision: Revise Major
14 Jan 20231st Revision Received
17 Jan 2023Submission Checks Completed
17 Jan 2023Assigned to Editor
17 Jan 2023Review(s) Completed, Editorial Evaluation Pending
24 Jan 2023Editorial Decision: Accept