Innate Immunity in normal and adverse pregnancy

摘要: In pregnancy, successful implantation, placental development and fetal growth, as well as maintenance of both maternal, and fetal health, requires balance of the immune response. Excessive activation of the immune system increases risk of rejection of the fetus and adverse pregnancy outcomes. In addition, disturbances in the immune system can lead to maternal or fetal infection. Due to cross-talk, both innate, and adaptive immunity must be properly regulated. Both our current topic “Innate Immunity in Normal and Adverse Pregnancy” and the parallel topic “Adaptive Immunity in Pregnancy” attracted 10–12 manuscripts. The articles in our topic included original research and comprehensive reviews and fell into 3 general categories: role of complement system, importance of innate immune cells, and an evaluation of innate immunity in infections in pregnancy. Each category evaluated the innate response in orchestrating a normal pregnancy or contributing to pathophysiology of adverse pregnancy outcomes (Figure 1). The timeliness of this topic is highlighted by the clear contribution of innate immunity to the pathology of COVID-19 infection and the potential impact on pregnancy outcomes (1, 2). This topic also synchronizes with the recent call by the Surgeon General in the United States indicating “we can—and must—do more for our moms” in reducing morbidity and mortality in pregnancy (https://www. hhs. gov/sites/default/files/call-to-action-maternal-health. pdf).