Immunomodulation of the mother during pregnancy.

The concept that the immune responsiveness of the mother is reduced during pregnancy arose from studies which appeared to show that immune response to certain antigens is reduced during pregnancy (1, 2). Various substances claimed to have immunosuppressive or immunomodulating effect include alpha fetoprotein, placental proteins, early pregnancy factor (EPF), human chorionic gonadotropin (HCG), corticosteroids, estrogens, androgens and progesterone (2). To summarise a body of literature, there is very little change in the immune competence of the mother during pregnancy. This makes sense, as generalized immunosuppression would be a risky way to ensure the survival of the fetus. Immune enhancement and subsequent immunomodulation of the mother is likely to be the mechanism operative during pregnancy. It is conceivable that the overall immune response in pregnancy could be the net result of an interplay of various interactions that may be operating to ensure non-rejection of the antigenically alien fetus while at the same time preventing a state of excessive immunosuppression. Such a dynamic homeostatic mechanism appears to be important for the successful completion of pregnancy.