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Am J Perinatol 2016; 33(14): 1337-1356
DOI: 10.1055/s-0036-1582397
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Inflammation in Complicated Pregnancy and Its Outcome

Ram R. Kalagiri
1   Department of Neonatology, Baylor Scott and White Health, Temple, Texas
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
,
Timothy Carder
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
,
Saiara Choudhury
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
,
Niraj Vora
1   Department of Neonatology, Baylor Scott and White Health, Temple, Texas
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
,
Amie R. Ballard
1   Department of Neonatology, Baylor Scott and White Health, Temple, Texas
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
3   Department of Pediatrics, Baylor Scott and White Health, Temple, Texas
,
Vinayak Govande
1   Department of Neonatology, Baylor Scott and White Health, Temple, Texas
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
3   Department of Pediatrics, Baylor Scott and White Health, Temple, Texas
,
Nathan Drever
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
4   Department of Obstetrics and Gynecology, Baylor Scott and White Health, Temple, Texas
,
Madhava R. Beeram
1   Department of Neonatology, Baylor Scott and White Health, Temple, Texas
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
3   Department of Pediatrics, Baylor Scott and White Health, Temple, Texas
,
M. Nasir Uddin
2   Texas A&M Health Science Center College of Medicine, Temple, Texas
3   Department of Pediatrics, Baylor Scott and White Health, Temple, Texas
4   Department of Obstetrics and Gynecology, Baylor Scott and White Health, Temple, Texas
5   Internal Medicine, Baylor Scott and White Health, Temple, Texas
› Author Affiliations
Further Information

Publication History

14 January 2016

26 February 2016

Publication Date:
09 May 2016 (online)

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Abstract

Background Normal pregnancy relies on a careful balance between immune tolerance and suppression. It is known that strict regulation of maternal immune function, in addition to components of inflammation, is paramount to successful pregnancy, and any imbalance between proinflammatory and anti-inflammatory cytokines and chemokines can lead to aberrant inflammation, often seen in complicated pregnancies. Inflammation in complicated pregnancies is directly associated with increased mortality and morbidity of the mother and offspring. Aberrant inflammatory reactions in complicated pregnancies often lead to adverse outcomes, such as spontaneous abortion, preterm labor, intrauterine growth restriction, and fetal demise. The role of inflammation in different stages of normal pregnancy is reviewed, compared, and contrasted with aberrant inflammation in complicated pregnancies. The complications addressed are preterm labor, pregnancy loss, infection, preeclampsia, maternal obesity, gestational diabetes mellitus, autoimmune diseases, and inflammatory bowel disease.

Aim This article examines the role of various inflammatory factors contributing to aberrant inflammation in complicated pregnancies. By understanding the aberrant inflammatory process in complicated pregnancies, novel diagnostic tools and therapeutic interventions for modulating it appropriately can be identified.

Keywords

preeclampsia - inflammation - pregnancy outcome - cytokines - chemokines - toll-like receptor - diabetes