Objective: To explore maternal humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the rate of vertical transmission. Design: A prospective cohort study. Setting: Two university-affiliated medical centers in Israel. Population: Women positive for SARS-CoV-2 reverse-transcription-polymerase-chain-reaction (RT-PCR) test, during pregnancy were enrolled just prior to delivery. Methods: Levels of anti-SARS-CoV-2 spike-IgM, spike-IgG and nucleocapsid-IgG were tested in maternal and cord blood at delivery, and neonatal nasopharyngeal swabs were subjected to PCR testing. Main outcomes measures: The primary endpoint was the rate of vertical transmission, defined as either positive neonatal IgM, positive neonatal IgG with sero-negative mother or positive neonatal PCR. Results: Among 72 women, 36 (50%), 39 (54%) and 30 (42%) were positive for anti-spike-IgM, anti-spike-IgG and anti-nucleocapsid-IgG, respectively (p<0.0001 for IgG antibodies-comparison). At least 8/72 (11%) neonates were infected in utero; one had a positive PCR result and seven had positive IgG antibodies while their mothers were seronegative for the same IgG. IgM was not detected in cord blood. Anti-nucleocapsid-IgG and anti-spike-IgG were detected in 83% and 85% of neonates of seropositive mothers, respectively (Pearson coefficient correlation 0.8, p<0.001). The highest rate of positive maternal serology tests was 8-12 weeks post-infection (89% anti-spike IgG, 78% anti-spike-IgM and 67% anti-nucleocapsid-IgG). Thereafter, the rate of positive serology tests declined gradually; at 20 weeks post-infection, only anti-spike-IgG was detected in 33-50%. Conclusions: The rate of vertical transmission was at least 11%. Vaccination should be considered 3 months post-infection in pregnant women due to a decline in antibody levels.

Background: Team-based learning (TBL) is a structured form of small-group learning for students which emphasizes out-of-class preparation towards guided application of knowledge in class. Values and knowledge education (VaKE) is a teaching method in which a “dilemma” is used as a motivation and trigger of knowledge acquisition. The goal of this study was to compare and evaluate medical students’ knowledge and achievements in a combination of these two methods (TBL+VaKE) vs. TBL alone. Methods: Every academic year we teach 3-4 groups of 8-10 medical students in each group, at their 5th year of MD studies. We recruited all groups of students since we started the study and alternately used one of the educational approaches on them, TBL or TBL+VaKE. Our study’s module was “diabetes in pregnancy”. Results: On all issues, the TBL+VaKE received higher scores. The difference for “complexity of decision making” question reached statistical significance. Furthermore, when we compared the two groups questionnaire answers, we detected statistical significance of p=0.02 (T test) for the difference between the two sets of scores. Conclusions: “Diabetes and pregnancy” module for 5th year meducal school students had better knowledge acquisition when a moral dilemma was added to the module (TBL+VaKE vs TBL).