Chapter 100 - Maternal Genital Tract Infection and the Neonate

Abstract

This chapter provides a brief overview of maternal immunization, the local female immune response to several common sexually transmitted diseases (STDs), and the possible impact on maternal and child health of controlling these infections. Experimental evidence indicates that the mucosal surfaces of the female genital tract are able to mount a locally induced specific-antibody and specific cell-mediated immune response. The local antibody response is independent of the serum antibody response and is mostly associated with secretory (S)-IgA immunoglobulin and locally reactive lymphocyte populations. The sparse amount of IgA-immunocompetent cells in the female genital tract may be largely derived from immunoreactive cells from the gastrointestinal tract—particularly Peyer's patches (PP). Data regarding the immune response of the breast suggests that a similar population of antigen-primed IgA producing cells from the gastrointestinal (GI) tract migrates to the female breast and secretes specific IgA into the milk. Thus, antigen exposure in the gut-associated lymphoid tissue (GALT) produces a sharing of immune experience at all mucosal surfaces—with particular enhancement at the surface of secondary exposure, in the case of genital tract.