Impacts of maternal excess adiposity on the uterine immune environment: contributions to placental dysfunction and adverse pregnancy outcomes
Bibliographic record
Abstract
In brief: Maternal excess adiposity (i.e. overweight and obesity) increases the risk of obstetrical complications, adverse pregnancy outcomes, and chronic health conditions postnatally. These risks are partly rooted in poor placental development and function. Compositional and functional disturbances to uterine-resident immune cells are likely to contribute to the increased burden of placental malperfusion and inflammatory injury seen in pregnancies complicated by overweight and obesity. Here, we summarize the current knowledge surrounding how excess adiposity influences the tissue-resident immune milieu of the uterus during the periconceptional period and across gestation. Abstract: Dynamic compositional and functional changes in the uterine immune environment occur across pregnancy to support placental development and fetal growth. Parental exposures that modify the differentiation, trafficking, or effector functions of uterine-resident immune cells, including chronic health conditions, have been linked to placental dysfunction and the development of obstetrical complications. Overweight and obesity (i.e. excess adiposity) is the most common chronic condition affecting pregnant people in most Westernized countries and is associated with an increased risk of multiple obstetrical complications underpinned by poor placental development and function. Emerging evidence supports the notion that maternal excess adiposity is linked to an altered immune landscape at the uteroplacental interface beginning early in pregnancy. This likely contributes to the development of malperfusion and inflammatory injury that fuels placental dysfunction and primes for adverse pre- and postnatal outcomes. However, a comprehensive understanding of how maternal excess adiposity affects the uterine immune milieu is currently lacking, particularly during the critical stages of placental development. In this review, we provide a summary of current knowledge regarding the ontogeny and function of tissue-resident leukocytes at the uteroplacental interface, focusing on the major populations of innate immune cells that contribute to placental development in humans. We also discuss the impacts of maternal obesity on placental development and function, how these outcomes may be related to the findings from recent periconceptional immunophenotyping studies and outline important areas for future investigation in this field.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".