Respiratory syncytial virus neutralizing antibodies in cord blood, respiratory syncytial virus hospitalization, and recurrent wheeze.
BACKGROUND
Respiratory syncytial virus (RSV) hospitalization is associated with wheeze.


OBJECTIVE
To examine the influence of maternally derived RSV neutralizing antibodies in cord blood on RSV hospitalization and recurrent wheeze in infancy.


METHODS
Among children from the Danish National Birth Cohort, we selected a subcohort of 459 randomly selected children, 408 children with RSV hospitalization, 408 children with recurrent wheeze, and all 289 children who experienced both RSV hospitalization and recurrent wheeze. The influence of cord blood RSV neutralizing antibodies was examined as predictors for (1) RSV hospitalization, (2) RSV hospitalization after recurrent wheeze, (3) recurrent wheeze, and (4) recurrent wheeze after RSV hospitalization.


RESULTS
Neutralizing antibody levels were inversely associated with RSV hospitalization in infants below 6 months of age (adjusted incidence rate ratio [IRR], 0.74; 95% CI, 0.62-0.87), and also inversely associated with RSV hospitalization in infants with recurrent wheeze (IRR, 0.83; 0.71-0.97). In contrast, neutralizing antibody levels were directly associated with an increased risk of recurrent wheeze in infants below 6 months of age (IRR, 1.28; 1.04-1.57) and with an increased risk of recurrent wheeze after RSV hospitalization in infants below 6 months of age (IRR, 1.44; 1.10-1.90).


CONCLUSIONS
Maternally derived RSV neutralizing antibodies protect infants against RSV hospitalization, and also when the infant has recurrent wheeze. However, high maternally derived RSV neutralizing antibody levels were associated with an increased risk of recurrent wheeze.
Stensballe
Lone Graff
LG
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Ravn
Henrik
H
Kristensen
Kim
K
Agerskov
Kenneth
K
Meakins
Tiffany
T
Aaby
Peter
P
Simões
Eric A F
EA
D000914:Antibodies, Viral / Q000097:blood*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood / Q000276:immunology* / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008431:Maternal-Fetal Exchange / Q000276:immunology*; D009500:Neutralization Tests; D011247:Pregnancy; D012008:Recurrence; D012135:Respiratory Sounds / Q000175:diagnosis / Q000276:immunology*; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D018113:Respiratory Syncytial Virus, Human / Q000276:immunology*; D011795:Surveys and Questionnaires
D000914:Antibodies, Viral