Abstract
Events in fetal life impact long-term health outcomes. The placenta is the first organ to form and is the site of juxtaposition between the maternal and fetal circulations. Most diseases of pregnancy are caused by, impact, or are reflected in the placenta. The purpose of this review is to describe the main inflammatory processes in the placenta, discuss their immunology, and relate their short- and long-term disease associations. Acute placental inflammation (API), including maternal and fetal inflammatory responses corresponds to the clinical diagnosis of chorioamnionitis and is associated with respiratory and neurodevelopmental diseases. The chronic placental inflammatory pathologies (CPI), include chronic villitis of unknown etiology, chronic deciduitis, chronic chorionitis, eosinophilic T-cell vasculitis, and chronic histiocytic intervillositis. These diseases are less-well studied, but have complex immunology and show mechanistic impacts on the fetal immune system. Overall, much work remains to be done in describing the long-term impacts of placental inflammation on offspring health.
Highlights
The developmental origins of health and disease (DOHaD) theory, in which in utero or early life events can have a significant impact on adult outcomes, has become the organizing principle of fetal and perinatal biology [1–3]
Extensive research has focused on maternal nutritional status and later metabolic disease in offspring, but some of the most striking DOHaD findings come from examination of the long term impact of exposure to inflammation
Placental inflammation is a sub-focus in the study of chronic disease risk, Placental Inflammation, Origins of Disease within the context of the global obesity epidemic and low-level, chronic inflammation that is present in pregnant women with a high BMI
Summary
The developmental origins of health and disease (DOHaD) theory, in which in utero or early life events can have a significant impact on adult outcomes, has become the organizing principle of fetal and perinatal biology [1–3]. Extensive research has focused on maternal nutritional status and later metabolic disease in offspring, but some of the most striking DOHaD findings come from examination of the long term impact of exposure to inflammation. Placental inflammation is a sub-focus in the study of chronic disease risk, Placental Inflammation, Origins of Disease within the context of the global obesity epidemic and low-level, chronic inflammation that is present in pregnant women with a high BMI. We describe the associations with long-term outcomes and relate studies relevant to potential or known mechanisms
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