Learning from experience: cellular and molecular bases for improved outcome in subsequent pregnancies

American Journal of Obstetrics and Gynecology
Debra Goldman-WohlSimcha Yagel

Abstract

The frequencies of preeclampsia, fetal growth restriction, fetal demise, and low birthweight are lower in subsequent pregnancies. Enhanced maternal cardiovascular adaptation, shorter first and second stages of labor, and more robust lactation also have been observed in subsequent as compared with first pregnancies. We sought to investigate the cellular and molecular bases for better outcomes in subsequent pregnancies. Based on the knowledge that specialized immune cells at the maternal-fetal interface, decidual natural killer cells, promote development of the placental bed and conversion of the spiral arteries by secreting a myriad of angiogenic and growth factors, we asked whether decidual natural killer cells differ in subsequent as compared with first pregnancies. This idea stemmed from recent studies suggesting that natural killer cells, although part of the innate immune system, possess some features of adaptive immunity, including a certain type of immune cell memory, termed trained immunity. We found that decidual natural killer cells from parous women "remember pregnancy" and differ from decidual natural killer cells of primigravidae. Compared with the decidual natural killer cells of first pregnancy, these cells, that ...Continue Reading

Citations

Oct 21, 2019·Immunology·Leticia MoninVictoria Male
Sep 26, 2019·Immunological Reviews·Margaret E Feeney
Sep 19, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Monika SarkarNorah A Terrault
Jan 21, 2021·Reproductive Biomedicine Online·Hadas Ganer HermanArieh Raziel
Sep 1, 2020·Journal of Perinatal Medicine·Kenichiro MotomuraNardhy Gomez-Lopez
Mar 14, 2021·American Journal of Obstetrics and Gynecology·Simcha YagelDebra Goldman-Wohl
Sep 1, 2021·Journal of Reproductive Immunology·Pierre-Yves RobillardMalik Boukerrou

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