Cord-blood respiratory syncytial virus antibodies and respiratory health in first 5 years of life

Mari D Takashima; Keith Grimwood; Peter D Sly; Stephen B Lambert; Keith J Chappell; Daniel Watterson; Paul Young; Merci Kusel; Barbara Holt; Patrick Holt; Robert S Ware

doi:10.1002/ppul.25688

Cord-blood respiratory syncytial virus antibodies and respiratory health in first 5 years of life

Pediatr Pulmonol. 2021 Dec;56(12):3942-3951. doi: 10.1002/ppul.25688. Epub 2021 Sep 29.

Authors

Mari D Takashima¹, Keith Grimwood^{1

2}, Peter D Sly^{3

4}, Stephen B Lambert⁵, Keith J Chappell^{4

6}, Daniel Watterson^{4

6}, Paul Young^{4

6}, Merci Kusel⁷, Barbara Holt⁷, Patrick Holt⁷, Robert S Ware¹

Affiliations

¹ Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia.
² Departments of Infectious Diseases and Paediatrics, Gold Coast Health, Southport, Queensland, Australia.
³ Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
⁴ Australian Infectious Diseases Research Centre, The University of Queensland, St Lucia, Queensland, Australia.
⁵ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
⁶ School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia.
⁷ Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, Nedlands, Western Australia, Australia.

PMID: 34549896
DOI: 10.1002/ppul.25688

Abstract

Objective: To determine the potential longer-term effects of maternal antenatal respiratory syncytial virus (RSV) vaccination, we examined the association between cord-blood RSV-neutralizing antibodies (RSV-NA) and RSV infections in the first 2 years of life, RSV-NA at 3 years, and respiratory health to age 5 years.

Methods: Two community-based Australian birth cohorts were combined. For children with at least one atopic parent, paired serum RSV-NA levels were compared in cord blood and at age 3 years. Weekly nasal swabs were collected in one cohort and during acute respiratory infections (ARI) in the other. Wheeze history up to age 5 years and physician-diagnosed asthma at 5 years was collected by parent report.

Results: In 264 children, each log₁₀ increase of cord-blood RSV-NA level was associated with 37% decreased risk (adjusted incidence-rate-ratio [aIRR] 0.63; 95% confidence interval [CI]: 0.40-1.01) of RSV-ARI and 49% decreased risk (aIRR 0.51; 95% CI: 0.25-1.02) of RSV acute lower respiratory infections (ALRI) at 12-24 months of age. However, higher cord-blood RSV-NA was associated with increased risk of all-cause ALRI (aIRR 1.29; 95% CI: 0.99-1.69), wheeze-associated ALRI (aIRR 1.75; 95% CI: 1.08-2.82), and severe ALRI (aIRR 2.76; 95% CI: 1.63-4.70) at age 6-<12 months. Cord-blood RSV-NA was not associated with RSV-ARI in the first 6-months, RSV-NA levels at 3 years, or wheeze or asthma at 5 years.

Conclusions: Higher levels of cord-blood RSV-NA did not protect against RSV infections during the first 6-months-of-life, time-to-first RSV-ARI, or wheeze or asthma in the first 5 years of life. Additional strategies to control RSV-related illness in childhood are needed.

Keywords: asthma; child; cord-blood antibodies; respiratory syncytial virus.

MeSH terms

Australia / epidemiology
Birth Cohort
Child
Child, Preschool
Female
Fetal Blood
Hospitalization
Humans
Infant
Pregnancy
Respiratory Syncytial Virus Infections* / epidemiology
Respiratory Syncytial Virus, Human*
Respiratory Tract Infections* / epidemiology