Preterm birth is the leading cause of mortality in children under the age of five worldwide. Despite major efforts, we still lack the ability to accurately predict and effectively prevent preterm birth. While multiple factors contribute to preterm labor, dysregulations of immunological adaptations required for the maintenance of a healthy pregnancy is at its pathophysiological core. Consequently, a precise understanding of these chronologically paced immune adaptations and of the biological pacemakers that synchronize the pregnancy "immune clock" is a critical first step towards identifying deviations that are hallmarks of peterm birth. Here, we will review key elements of the fetal, placental, and maternal pacemakers that program the immune clock of pregnancy. We will then emphasize multiomic studies that enable a more integrated view of pregnancy-related immune adaptations. Such multiomic assessments can strengthen the biological plausibility of immunological findings and increase the power of biological signatures predictive of preterm birth.

中文翻译：

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妊娠的多组学免疫发条。

早产是全世界五岁以下儿童死亡的主要原因。尽管付出了巨大努力，我们仍然缺乏准确预测和有效预防早产的能力。虽然导致早产的因素有多种，但维持健康妊娠所需的免疫适应失调是其病理生理学核心。因此，准确了解这些按时间顺序排列的免疫适应以及同步妊娠“免疫时钟”的生物起搏器是识别胎儿出生标志偏差的关键的第一步。在这里，我们将回顾对妊娠免疫时钟进行编程的胎儿、胎盘和母体起搏器的关键元件。然后，我们将强调多组学研究，这些研究能够更全面地了解与妊娠相关的免疫适应。这种多组学评估可以增强免疫学发现的生物学合理性，并增强生物特征预测早产的能力。