Evidence for maternal autoantibodies in the pathogenesis of preterm birth.

Pregnant women with preterm birth have a shared autoreactive antibody signature, including anti-IL1RA, that may contribute to pregnancy complications.

• Why it matters: Understanding self-reactive antibodies in pregnancy could reveal mechanisms behind preterm birth, which is a leading cause of child mortality worldwide, and has been linked mainly to allo- and autoantibodies.
• What they did: Proteome-wide autoantibody profiling was performed on sera from 2,719 pregnant women and 130 never-pregnant controls, comparing 688 preterm and 1,505 term pregnancies across eight cohorts.
• The result: Anti-IL1RA antibodies, part of the pregnancy-associated autoreactive signature, induce resorption, inflammation, and vascular malperfusion in pregnant mice, suggesting a potential pathogenic role in preterm birth.