With pregnancy comes not just new life, but also the collection of huge amounts of data and numerous doctor visits to ensure the health of the mother and child. The pregnant body undergoes myriad biological changes that can give rise to problems that yield a bad result that all involved want to avoid.
A whole cottage industry of direct-to-consumer (DTC) products/services has sprung up, aimed at providing peace-of-mind health information between doctor visits. However, many of these products are likely having the opposite effect, creating more anxiety, more doctor visits and more unnecessary medical care (Thielking, 2019). Although the direction of prenatal care is toward greater empowerment of the mother and her supporters, the technology at hand (and the data it provides) is simply not yet good enough to have a positive rather than negative impact.
What data/technology should we be pursuing? A recent study in marsupials aimed at understanding how embryo implantation evolved provides a hint (Griffith et al., 2017). The research team noted that the implantation event appears to modify the normal inflammation response to a foreign body. The group suggests that this could explain the increased risk of miscarriage if a person is on anti-inflammatory medication during the implantation phase.
Griffith et al. further compared the gestation styles of marsupials and humans. Both humans and marsupials rely on inflammation for embryo implantation and for birth. Unlike marsupials, in which the newborn crawls into a pouch for further development to avoid the mother’s immune system, humans and other placental mammals do something different. After implantation, these creatures mount an anti-inflammation response until it is time to give birth. This gives the embryo time to mature and not be attacked by the mother’s immune system.
Monitoring the “on-off-on” cycling of the inflammatory response could be a great way to see how well the pregnancy is going and get early warning of problems from a mistimed immune response. (Also, this could be the sought-after answer to the question mentioned above.) One group is already on top of that and used the insightful SomaLogic® technology along with other information to monitor what happens to the immune system during the course of a pregnancy (Aghaeepour et al., 2017). Although the sample size was small, the group’s findings lay the groundwork for understanding what happens to the immune system during a healthy pregnancy in great detail. It could open the door to the possibility of new diagnostics to determine if a pregnant individual is at risk of problems with the pregnancy. It might be enough to put many worried minds at ease and reduce unnecessary doctor visits. Perhaps, it could even reduce the workload of practioners. Indeed, it might even revolutionize the field.
Aghaeepour, N., Ganio, E. A., McIlwain, D., Tsai, A. S., Tingle, M., Van Gassen, S., . . . Gaudilliere, B. (2017). An immune clock of human pregnancy. Sci Immunol, 2(15). doi:10.1126/sciimmunol.aan2946
Griffith, O. W., Chavan, A. R., Protopapas, S., Maziarz, J., Romero, R., & Wagner, G. P. (2017). Embryo implantation evolved from an ancestral inflammatory attachment reaction. Proc Natl Acad Sci U S A, 114(32), E6566-E6575. doi:10.1073/pnas.1701129114
Thielking, M. (2019, July 23) As pregnancy tech proliferates, women and their doctors wade through what’s helpful — and what’s a headache. STAT. Retrieved on August 5, 2019 from https://www.statnews.com/2019/07/23/pregnancy-tech-help-headache/.