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Background <p>COVID-19 in pregnancy is associated with complications for mother and baby (e.g., maternal admission to intensive care, preterm birth). There is little evidence on the prevalence of SARS-CoV-2 in pregnant women from Sub-Saharan Africa. Most studies used a small sample size within a short period and did not accurately assess prevalence as the pandemic progressed. This study aimed to determine the maternal seroprevalence of SARS-CoV-2 from the beginning of the pandemic until the end of the third wave in southern Mozambique.</p> Methods <p>This study was nested in the PRECISE study, a prospective observational cohort study of pregnant women enrolled at first antenatal care and followed up until delivery in The Gambia, Kenya, and Mozambique. For this study, samples were evaluated from October 2019 to March 2022 in Mozambique. Serum from all mothers (using Wantai SARS-CoV-2 Ab ELISA) and cord blood from a random sample of SARS-CoV-2 positive mothers (by the Euroimmun test) were tested. The seroprevalence was calculated as proportions with 95% confidence intervals (CIs). Bivariate logistic regression was used to test associations between the presence of SARS-CoV-2 antibodies and the time and place of sample collection, with <i>p</i>-value &lt; 0.05 considered statistically significant.</p> Results <p>From PRECISE Mozambique, 2080 women contributed 3392 samples, 1651 at the time of antenatal recruitment and 1741 on admission for delivery. The mean seroprevalence in the tested samples was 26.2% and varied from 4.9% [95% CI 2.4–8.9] pre-pandemic to 82% [95% CI 71.8–90.3] after the third wave. In a subsample of 215 mothers Wantai seropositive, seroprevalence by Euroimmun was 47.4% in maternal serum and 40.9% in cord blood. Except for the first wave, where the prevalence in maternal serum was high, there were no differences in prevalence in maternal serum and cord blood among the waves.</p> Conclusions <p>The study reported a rising seroprevalence for antibodies to SARS-CoV-2 in pregnancy, particularly in the third wave when the Omicron variant predominated. In a subsample, the prevalence of SARS-CoV-2 in maternal serum was similar to that in cord blood, indicating good antibody transfer from mother to child. We found positivity with the Wantai test in the pre-pandemic period but not with Euroimmun, indicating the need for test validation in different geographies and contexts.</p>

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SARS-CoV-2 seroprevalence among pregnant women during the first three waves of the COVID-19 pandemic in southern Mozambique

  • 期刊论文

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  • 发表日期：

    2026年5月20日

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  • Esperança Sevene,
  • Sónia Maculuve,
  • Corssino Tchavana,
  • Anifa Valá,
  • Lázaro Quimice,
  • Salésio Macuacua,
  • Carla Carrilho,
  • Raquel Gonzalez,
  • Tacilta Nhampossa,
  • Clara Menendez,
  • Rachel Craik,
  • Lauren Hookham,
  • Kirsty Le Doare,
  • Peter von Dadelszen,
  • Umberto D’Alessandro,
  • Anna Roca,
  • Hawanatu Jah,
  • Andrew Prentice,
  • Melisa Martinez-Alvarez,
  • Brahima Diallo,
  • Abdul Sesay,
  • Sambou Suso,
  • Yahaya Idris,
  • Baboucarr Njie,
  • Fatima Touray,
  • Fatoumata Kongira,
  • Modou F. S. Ndure,
  • Gibril Gabbidon,
  • Lawrence Gibba,
  • Abdoulie Bah,
  • Yorro Bah,
  • Marleen Temmerman,
  • Angela Koech,
  • Patricia Okiro,
  • Geoffrey Omuse,
  • Grace Mwashigadi,
  • Consolata Juma,
  • Joseph Mutunga,
  • Moses Mukhanya,
  • Onesmus Wanje,
  • Isaac Mwaniki,
  • Marvin Ochieng,
  • Emily Mwadime,
  • Helena Boene,
  • Inacio Mandomando,
  • Laura A. Magee,
  • Marie-Laure Volvert,
  • Hiten Mistry,
  • Thomas Mendy,
  • Donna Russell,
  • Prestige Tatenda Makanga,
  • Liberty Makacha,
  • Reason Mlambo,
  • Lucilla Poston,
  • Rachel Tribe,
  • Sophie Moore,
  • Tatiana Salisbury,
  • Aris Papageorghiou,
  • Alison Noble,
  • Rachel Craik,
  • Hannah Blencowe,
  • Veronique Filippi,
  • Joy Lawn,
  • Matt Silver,
  • Joseph Akuze,
  • Ursula Gazeley,
  • Judith Cartwright,
  • Guy Whitley,
  • Sanjeev Krishna,
  • Marianne Vidler,
  • Jing Larry Li,
  • Jeff Bone,
  • Mai-Lei Maggie Woo Kinshella,
  • Domena Tu,
  • Ash Sandhu,
  • Kelly Pickerill,
  • Liberty Cantrell,
  • Madeleine Cochet,
  • Stephen Cose,
  • Melanie Etti,
  • Bridget Freyne,
  • Luis Gadama,
  • Lauren Hookham,
  • Hawanatu Jah,
  • Angela Koech,
  • Esther Imede,
  • Kondwani Kawaza,
  • Samantha Lissauer,
  • Robert Mboizi,
  • Philippa Musoke,
  • Victoria Nankabirwa,
  • Geoffrey Omuse,
  • Joseph Ouma,
  • Gordon Rukondo,
  • Musa Sekikubo,
  • Halvor Sommerfelt,
  • Merryn Voysey

摘要

Background

COVID-19 in pregnancy is associated with complications for mother and baby (e.g., maternal admission to intensive care, preterm birth). There is little evidence on the prevalence of SARS-CoV-2 in pregnant women from Sub-Saharan Africa. Most studies used a small sample size within a short period and did not accurately assess prevalence as the pandemic progressed. This study aimed to determine the maternal seroprevalence of SARS-CoV-2 from the beginning of the pandemic until the end of the third wave in southern Mozambique.

Methods

This study was nested in the PRECISE study, a prospective observational cohort study of pregnant women enrolled at first antenatal care and followed up until delivery in The Gambia, Kenya, and Mozambique. For this study, samples were evaluated from October 2019 to March 2022 in Mozambique. Serum from all mothers (using Wantai SARS-CoV-2 Ab ELISA) and cord blood from a random sample of SARS-CoV-2 positive mothers (by the Euroimmun test) were tested. The seroprevalence was calculated as proportions with 95% confidence intervals (CIs). Bivariate logistic regression was used to test associations between the presence of SARS-CoV-2 antibodies and the time and place of sample collection, with p-value < 0.05 considered statistically significant.

Results

From PRECISE Mozambique, 2080 women contributed 3392 samples, 1651 at the time of antenatal recruitment and 1741 on admission for delivery. The mean seroprevalence in the tested samples was 26.2% and varied from 4.9% [95% CI 2.4–8.9] pre-pandemic to 82% [95% CI 71.8–90.3] after the third wave. In a subsample of 215 mothers Wantai seropositive, seroprevalence by Euroimmun was 47.4% in maternal serum and 40.9% in cord blood. Except for the first wave, where the prevalence in maternal serum was high, there were no differences in prevalence in maternal serum and cord blood among the waves.

Conclusions

The study reported a rising seroprevalence for antibodies to SARS-CoV-2 in pregnancy, particularly in the third wave when the Omicron variant predominated. In a subsample, the prevalence of SARS-CoV-2 in maternal serum was similar to that in cord blood, indicating good antibody transfer from mother to child. We found positivity with the Wantai test in the pre-pandemic period but not with Euroimmun, indicating the need for test validation in different geographies and contexts.