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Cord blood and breast-milk antibodies in neonatal rotavirus infection
Insights
Rotavirus antibodies in cord blood and breast milk did not prevent infection in newborns. Other factors likely protect infants from rotavirus during outbreaks.
Area of Science:
- Neonatal Immunology
- Virology
- Public Health
Background:
- Rotavirus infection poses a significant risk to neonates, particularly during nursery outbreaks.
- Understanding the role of maternal antibodies in protecting newborns is crucial for infection control strategies.
Purpose of the Study:
- To investigate the protective role of rotavirus-specific antibodies in neonatal cord blood and maternal breast milk.
- To determine the correlation between antibody levels and rotavirus excretion in neonates.
Main Methods:
- Analysis of rotavirus-specific antibody levels (IgA, IgG) in cord blood and expressed breast milk.
- Quantification of rotavirus excretion in neonates.
- Comparison of antibody titres between rotavirus-positive and rotavirus-negative neonates and their mothers.
Main Results:
- No significant difference in rotavirus-specific antibody levels in cord blood between infected and non-infected neonates.
- Similar patterns of rotavirus-specific IgA and IgG antibodies in breast milk of mothers with infected and non-infected babies.
- Higher prevalence and titres of rotavirus IgA antibodies against group 2 and type 2 strains in breast milk, but no correlation with reduced viral excretion in breastfed infants.
Conclusions:
- Neonatal rotavirus infection is not solely prevented by rotavirus-specific antibodies present in cord blood or breast milk.
- Factors beyond maternal antibodies in breast milk are critical for protecting newborns against rotavirus infection.
- Further research is needed to identify other protective mechanisms against neonatal rotavirus.
Abstract:
Studies were carried out during an outbreak of rotavirus type 2 infection in a neonatal nursery to determine the protective role of antibodies in cord blood and breast milk. The range, distribution, and geometric mean titres of rotavirus-specific antibody in the cord blood were similar among rotavirus-positive and rotavirus-negative neonates, and the amount of virus excreted did not correlate with antibody levels. Despite the protective effect of breast feeding, the pattern of rotavirus-specific IgA and IgG antibodies in the expressed breast milk of mothers of babies who were rotavirus excreters and non-excreters was similar. Nevertheless, a higher proportion of expressed breast milk samples contained rotavirus-specific IgA group 2 (92%) and type 2 (97%) specific antibodies than type I (67%) antibodies, and the geometric mean titres of group 2 and type 2 specific antibodies were tenfold higher than type I antibodies. Among breast-fed babies who excreted rotavirus there was no correlation between type 2 rotavirus-specific IgA antibodies in expressed breast milk and the amount of neonatal virus excretion. These studies suggest that factors other than the rotavirus antibodies in expressed breast milk are of importance in preventing rotavirus infection in newborn infants.