This Research Topic is the second volume of the “Fetal-Maternal Immune Interactions in Pregnancy” Community Series. Please see the first volume here".

Fetal-maternal immune interactions in pregnancy represent a critical area of research due to the unique nature of human haemochorial placentation, which involves deep trophoblast invasion and intimate contact between maternal and fetal cells. The establishment and maintenance of pregnancy require finely tuned immune interactions and tolerance mechanisms, encompassing cellular, microvesicular, and molecular communication between the mother and fetus. However, these interactions can be disrupted by placental malfunction, systemic maternal inflammation or infection, and local uterine infections, leading to a range of pregnancy complications. Humans exhibit a notably high rate of implantation failure, miscarriages, and obstetrical syndromes such as preeclampsia and intrauterine growth restriction, with significant implications for both maternal and fetal health. These complications not only pose immediate risks but also predispose affected individuals to long-term health issues, including metabolic and cardiovascular diseases. Despite the overlapping placental pathologies, the clinical manifestations and outcomes of these complications vary widely, complicating early diagnosis and personalized treatment strategies. Understanding the intricate signaling pathways and gene regulatory networks involved is essential for advancing perinatal medicine.

This research topic aims to consolidate recent advancements in understanding fetal-maternal immune interactions during pregnancy. The primary objectives include elucidating how fetal cells and placental molecules influence maternal immune regulation, examining the role of maternal immune cells in modulating placental functions, and investigating the impact of maternal infections and inflammation on placental and fetal development. Additionally, the research seeks to explore how systems biological approaches can stratify patients based on disease pathways, ultimately leading to the development of novel diagnostic and personalized therapeutic tools.

To gather further insights into the complex interplay of factors affecting pregnancy outcomes, we welcome articles addressing, but not limited to, the following themes:
- Mechanisms by which fetal cells and placental molecules regulate maternal immune responses.
- The role of maternal immune cells in influencing placental function and health.
- The effects of maternal infections and inflammation on fetal development and long-term health outcomes.
- Application of systems biology to identify disease pathways and develop personalized diagnostic and therapeutic strategies.
- Exploration of (epi)genetic, hormonal, metabolic, nutritional, and environmental factors influencing pregnancy complications.

Topic editor Dr. Nandor Gabor Than is the founder, CEO and employed by Genesis Theranostix Ltd and Genesis Theranostix Inc. All other Topic Editors declare no competing interests with regards to the Research Topic subject.

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Frontiers in Immunology

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