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Updated: Jan 16, 2026
An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Cord Blood RSV-Neutralizing Antibodies and Risk of Hospitalization for RSV-Associated Acute Respiratory Infection in
Michiko Toizumi1, Yutaro Yamagata1, Hien Anh Thi Nguyen2
1Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan.
Insights
Infants born with low levels of respiratory syncytial virus (RSV)-specific neutralizing antibodies (nAbs) face a higher risk of hospitalization from RSV-associated acute respiratory infection (RSV-ARI) in early life. Maternal immunization may improve infant protection.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Respiratory syncytial virus (RSV) is a major cause of severe respiratory infections in infants.
- Maternal antibodies transferred to infants may offer protection, but their effectiveness is not fully understood.
Purpose of the Study:
- To examine the link between cord blood RSV-A neutralizing antibody (nAb) levels and the risk of hospitalization for RSV-associated acute respiratory infection (RSV-ARI) up to 24 months of age.
Main Methods:
- A case-cohort study was conducted in Vietnam.
- RSV-A nAb titers were measured in cord blood from infants in a birth cohort.
- Weighted Cox proportional hazards regression analyzed the association between nAb levels and RSV-ARI hospitalization risk.
Main Results:
- Lower RSV-A nAb titers at birth were associated with a significantly higher risk of RSV-ARI hospitalization in infants under 6 months.
- Maternal anemia was also linked to an increased risk of hospitalization.
Conclusions:
- Low levels of maternal antibodies against RSV at birth increase infant hospitalization risk for RSV-ARI.
- Maternal immunization strategies are crucial for enhancing infant protection against RSV.
Background:
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections in children, particularly severe during infancy. Maternal RSV-specific neutralizing antibodies (nAbs), transferred via the placenta, may provide protection in early infancy, but the extent and duration of protection remain uncertain.
Objective:
We investigated the association between cord blood RSV-A nAb levels and the risk of hospitalization due to RSV-associated acute respiratory infection (RSV-ARI) by 24 months of age.
Methods:
We conducted a case-cohort study nested within a birth cohort in Nha Trang, Vietnam. From the full cohort (n = 1977), a random subcohort of 392 infants and all 66 infants hospitalized for RSV-ARI by age 24 months were included for RSV-A nAb testing. RSV-A nAb titers at birth were categorized into three groups in the subcohort (low: lowest quartile; middle; interquartile; high: highest quartile). Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) for RSV-ARI hospitalization.
Results:
The incidence of RSV-ARI hospitalization was 17.92 per 1000 person-years by 24 months, and 25.40 per 1000 person-years among infants aged <12 months. Among infants aged <6 months, those in the low nAb group had a significantly higher risk of hospitalization compared to the middle nAb group (adjusted HR: 4.05; 95% CI: 1.51-10.89). Maternal anemia was consistently associated with increased risk.
Conclusions:
Lower RSV-nAb titers at birth were associated with an increased risk of RSV-ARI hospitalization during early infancy. These findings support the importance of maternal immunization strategies to enhance infant protection against RSV.
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