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Miscarriage syndrome : linking early pregnancy loss to obstetric and age-related disorders

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Bortoletto, Pietro, Lucas, Emma S., Melo, Pedro, Gallos, Ioannis D., Devall, Adam J., Bourne, Tom, Quenby, Siobhan, Bennett, Phillip R., Coomarasamy, Arri and Brosens, Jan J. (2022) Miscarriage syndrome : linking early pregnancy loss to obstetric and age-related disorders. EBioMedicine, 81 . 104134. doi:10.1016/j.ebiom.2022.104134 ISSN 2352-3964.

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Official URL: http://dx.doi.org/10.1016/j.ebiom.2022.104134

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Abstract

Upon embryo implantation, the uterine mucosa - the endometrium - transforms into a robust decidual matrix that accommodates the fetal placenta throughout pregnancy. This transition is driven by the differentiation of endometrial fibroblasts into specialised decidual cells. A synchronised influx of circulating natural killer (NK) cells and bone marrow-derived mesenchymal stem/progenitor cells (BM-MSC) is pivotal for decidual homeostasis and expansion in early pregnancy. We hypothesise that pathological signals interfering with the recruitment or activity of extrauterine cells at the maternal-fetal interface link miscarriage to subsequent adverse pregnancy outcomes, including further pregnancy losses and preterm labour. NK cells and BM-MSC are key homeostatic regulators in multiple tissues, pointing towards a shared aetiology between recurrent miscarriage and age-related disorders, including cardiometabolic disease. We propose the term ‘miscarriage syndrome’ to capture the health risks associated with miscarriage and discuss how this paradigm can inform clinical practice and accelerate the development of preventative strategies.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Miscarriage -- Research, Pregnancy -- Complications, Premature labor, Reproductive health
Journal or Publication Title: EBioMedicine
Publisher: Elsevier BV
ISSN: 2352-3964
Official Date: July 2022
Dates:
DateEvent
July 2022Published
29 June 2022Available
13 June 2022Accepted
Volume: 81
Article Number: 104134
DOI: 10.1016/j.ebiom.2022.104134
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 9 September 2022
Date of first compliant Open Access: 12 September 2022

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