Immunoglobulin G and subclasses placental transfer in fetuses and preterm newborns: a systematic review

Immunoglobulin G (IgG) and subclasses are the only class of antibodies capable of crossing placenta and providing protection against neonatal infectious diseases, especially in premature infants. This systematic review aimed to review the literature concerning the transplacental transfer of IgG and its subclasses in fetuses and preterm newborns and compare the results with data from term neonates. Eleven studies were included in the final review. Most studies demonstrated a lower transplacental passage of IgG2 than other subclasses in term and preterm newborns and a more efficient passage of total IgG and IgG1 after 37 weeks of gestational age. These results elucidate the physiology of IgG subclass transfer during pregnancy and may explain one of the reasons preterm newborns are especially susceptible to specific pathogens, such as encapsulated bacteria.