Mother's Immune System May Be Key to Delivery Date

In a study published in the American Journal of Obstetrics and Gynecology, an estimated 98% of all prematurely born infants survive their infancy, however approximately 44% of the ones born severely premature do not survive. If a child is born premature, not only do the immediate complications exist but long-term complications do as well, varying in different degrees from minor to life-long disabilities. There exist several groups of scientists currently each with different research driven approaches having the same overall goal in mind: to elucidate the conditions indicative of pre-term labor so that it can be avoided or in the very least so that steps may taken to increase the gestational age of the infant before delivery, decreasing avoidable complications and increasing the baby’s viability.

While a mother is pregnant with an unborn baby, throughout the stages of her pregnancy her body’s immune system is a symphony of give and take: certain aspects of the immune system must be lowered, so that the system does not view the infant as a foreign pathogen and pre-term labor induced as a result, and other aspects of the immune system must be increased so that throughout the gestation the mother’s body as well as the unborn’s are protected from externally introduced viral and bacterial pathogens. In an article published in Science Immunology, An Immune Clock of Human Pregnancy, the authors research and observe the maternal immune system for the complete duration of the gestation and post-natal by way of whole blood sampling of a sampling of pregnant women. High dimensional Mass cytometry was their method of bench research and had the benefit of allowing the scientists to observe over nine hundred and eighty four immunity features of the gestational immune response as well as a subset of twenty-four immune system cells directly in whole blood samples. Whole blood sampling is an advantageous medium in that it allowed the scientists to observe all immune cells present and their interactions with minimal disturbance to the balances of those cells from unnecessary laboratory method handling.

After all obtainable data was procured from the various blood samples taken throughout the different stages of gestation and several weeks post-natal, the scientists were able to apply and update a mathematical algorithm (referred to as csEN) that shows evidence of being a useful tool in a predicting gestational age at a labor: essentially whether a pregnancy may result in a pre-term labor or will carry out to full term. The algorithm computes the changes in a mother’s peripheral immune system over the entire length of her pregnancy and takes into consideration any deviations of the immune system that could be indicative of pre-term labor.

This continued research into the gestational immunity clock is allowing scientists and medical care providers to have access to laboratory tools that could at the very least signal when an expectant mother may go into labor early and allow for preparations to be made for a pre-term labor, and at most the avoidance of a pre-term labor entirely and successful full-term gestation.   High dimensional mass cytometry is a very useful tool, but is limited to allowing only fifty different parameters of the immune system to be analyzed at a time, thus being time-consuming for obtaining a full immune system snapshot. New scientific methods, specifically next generation sequencing, will allow for the further study of immune cells involved in gestation. NGS has the advantage through DNA sequencing for the elucidation and observation of upregulated and downregulated immune system cells signaling potential pre-term labor. With every research study and every advancement of scientific technology, science is one step closer to solving the pregnancy immunity clock.