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Inflammation and Pregnancy

Michael Johnson Foundation for Health Research, Vancouver, Canada

Charles J. Lockwood, MD

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut

Leslie Myatt, PhD

Department of Obstetrics and Gynecology, College of Medicine, University of Cincinnati, Cincinnati Ohio

Jane E. Norman, MD

Maternal and Fetal Health, University of Edinburgh Centre for Reproductive Biology, The Queen's Medical Research Institute, Edinburgh, United Kingdom

Jerome F. Strauss, III, MD, PhD

Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia

Felice Petraglia, MD

Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy, petraglia{at}unisi.it

Inflammation is a process by which tissues respond to various insults. It is characterized by upregulation of chemokines, cytokines, and pattern recognition receptors that sense microbes and tissue breakdown products. During pregnancy, the balance of Th1 (cell-mediated immunity) and Th2 (humoral immunity) cytokines is characterized by an initial prevalence of Th2 cytokines, followed by a progressive shift toward Th1 predominance late in gestation, that when is abnormal, may initiate and intensify the cascade of inflammatory cytokine production involved in adverse pregnancy outcomes. Maternal and placental hormones may affect the inflammatory pathway. Hypoxia and the innate immune response are 2 adaptive mechanisms by which organisms respond to perturbation in organ function, playing a major role in spontaneous abortion, intrauterine growth restriction, preeclampsia, and preterm delivery. The interaction between tissue remodeling factors, like matrix metalloproteinases, and vasoactive/hemostatic factors, like prostaglandin and coagulation factors, mediates this adaptive response.

Key Words: Inflammation • cytokines • hormones • prostaglandins • spontaneous abortion • preterm delivery • preeclampsia • intrauterine growth restriction.

Reproductive Sciences, Vol. 16, No. 2, 206-215 (2009)
DOI: 10.1177/1933719108329095


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