Abstract
The risk and severity of specific infections are increased during pregnancy due to a combination of physiological and immunological changes. Characterizing the maternal immune system during pregnancy is important to understand how the maternal immune system maintains tolerance towards the allogeneic fetus. This may also inform strategies to prevent maternal fatalities due to infections and optimize maternal vaccination to best protect the mother-fetus dyad and the infant after birth. In this review, we describe what is known about the immunological changes that occur during a normal pregnancy.
Highlights
During pregnancy, major adaptations occur in the maternal immune system to protect the mother and her future baby from pathogens while avoiding detrimental immune responses against the allogeneic fetus
We have described how the maternal immune system undergoes major adaptation during a healthy pregnancy
A large body of scientific literature that accumulated over years demonstrates significant systemic immunological adaptation during pregnancy (Figure 1)
Summary
Major adaptations occur in the maternal immune system to protect the mother and her future baby from pathogens while avoiding detrimental immune responses against the allogeneic fetus. Increased levels of TLR4 co-receptor CD14 and the Fc receptor CD64 on granulocytes in the second and third trimesters compared to non-pregnant women. Expression of the activation marker Human Neutrophil Antigen-2a (HNA-2a), known as NB1 or CD177, increases during pregnancy and remains elevated for at least 4–8 weeks postpartum compared to nonpregnant women [94].
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