Inflammation, pregnancy, and health

Elevated levels of inflammation in pregnancy are known to be associated with adverse birth outcomes, however, pregnancy itself is also an inflammatory process. Cytokines interact within complex regulatory networks to coordinate appropriate placentation and fetal development. My past work has found that the relative balance of pro- and anti-inflammatory cytokines during late pregnancy predicted offspring size at birth in a Filipino cohort, while individual cytokines did not. Mothers’ having elevated pro-inflammatory cytokines relative to anti-inflammatory cytokine levels in the third trimester was associated with lower birth weight and length of babies. Our findings demonstrated that dynamic maintenance of maternal inflammation via cytokine signaling, not just general inflammation, shapes prenatal development.

Recently, my coauthors and I demonstrated that locally relevant measures of maternal socioeconomic status in that same cohort were significantly negatively associated with late pregnancy pro-inflammatory signals, while relative inflammatory balance was slightly, non-significantly related to SES.

The inverse relationship between SES and inflammation is consistent with results from high-income settings, highlighting the importance of socioeconomic factors in pregnancy across demographic contexts.

Given the impacts of elevated inflammation on prenatal growth, these results suggest that immune alterations in response to structural inequality may be an important pathway for the perpetuation of poor growth and health disparities.