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What happens to the immune system during pregnancy?

When does immune system recover after pregnancy?

When does immune system recover after pregnancy?

Return to normal cellular immune function may take 3 to 4 months in the postpartum. Some aspects of early immunology (hsCRP and IL-6) probably reflect the latter stage of pregnancy, the stress of birth and the inflammation associated with involution.

What happens to the immune system during pregnancy?

Although it is now widely accepted that there is a finely tuned interaction between maternal and fetal cells to support a healthy pregnancy, many studies have used mouse models to investigate this – but mice are not humans.

New research published this week in the journal Science Immunology sheds new light on how the human immune system changes as pregnancy progresses.

In the study, Dr. Brice Gaudilliere – an assistant professor of anesthesiology, perioperative, and pain medicine at the March of Dimes Prematurity Research Center at Stanford University in California – and colleagues built a comprehensive model of how human immune cells behave during a normal pregnancy. Yet their long-term ambitions are to explore this even further.

Dr. Gaudilliere plans to conduct a similar study with women who experience preterm birth to see whether or not the team can pinpoint particular changes that might act as early warning signs.

Preterm birth – which is defined as birth before 37 weeks of pregnancy – is the leading cause of death in children under the age of 5, accordingTrusted Source to the World Health Organization (WHO). In 2015, this resulted in nearly 1 million deaths worldwide.

In the United States, the rateTrusted Source of preterm birth is 10 percent. And globally, the number of preterm births is on the increase. Those who survive can face life-long complications.

But why would the immune system play such a big role in pregnancy? And how is it linked to preterm birth?

Misconceptions corrected

For many years, the process of pregnancy was likened to that of organ transplantation, as Dr. Gil Mor – a professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine in New Haven, CT – and colleagues explain in a recent articleTrusted Source published in the journal Nature Reviews Immunology.

Scientists thought that the maternal immune system had to be repressed throughout pregnancy to stop it from rejecting the fetus. The presence of a host of immune cells at the site of implantation of the embryo was taken as evidence for this theory.

These cells were assumed to be battling the foreign embryonic cells, which were, in turn, trying to suppress this immune response. If the embryonic cells had the upper hand, implantation could proceed. But the battle continued throughout pregnancy.

If this process was not successful, it was thought to lead to miscarriages or pretermTrusted Source labor.

However, studies subsequently showed that the presence or recruitment of immune cells did not occur as a foreign-body response but was a requirement for successful implantation.

And it doesn’t stop there; current thinking is that the interplay between fetal cells and the mother’s immune response is a critical component throughout pregnancy.

Immune system in flux

To allow the developing embryo to implant, some of its cells actively invade the womb’s lining. This leads to an inflammatory cascade, similar to the events that occur during wound healing.

If inflammation is prevented from occurring, implantation cannot proceed, highlighting the importance of inflammatory molecules and cells in this process.

This pro-inflammatory environment dominates the first 12 weeks of pregnancy. During the following 15 weeks, the developing fetus is in a state of rapid growth and development. Anti-inflammatory cells and molecules prevail.

Some fetal cells express cell surface markers, or antigens, that originate from the father. Under normal circumstances, the mother’s immune system would recognize these as foreign and attack the cells.

Regulatory T cells (Tregs), which are a specialized form of white blood cell that promote an anti-inflammatory environment, actively protect such fetal cells.

Low levels of Tregs have been linked to miscarriage.

During the final stage of pregnancy, the immune system switches back to a pro-inflammatory state. Without this, the mother cannot go into labor. Preterm labor, in turn, may be associated with abnormal immune responses.

A host of factors influence how the immune system behaves during pregnancy, and increasingly, scientists believe that the mother’s microbiome has a part to play.

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