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

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)3942-3951
Number of pages10
JournalPediatric Pulmonology
Issue number12
Early online date22 Sept 2021
Publication statusPublished - Dec 2021


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