The influence of transmitted parasitic infections during pregnancy on fetal immunity system (literature review)




protozoa, helminths, congenital infections, immunity, allergy


Transmission of infections during pregnancy is known to alter the development and functioning of the fetus immune system, resulting in an inadequate immune response to common childhood infections and immunizations. Although it is a developing and actively researched topic, maternal parasitic infections remain poorly understood. Millions of women of reproductive age are currently at risk of parasite infection, while many pregnant, chronically infected women are excluded from mass drug administration due in part to a lack of resources, as well as fear of unknown adverse fetal outcomes. infection, there is no clear mechanism for understanding how maternal infection reprograms offspring immunity.

Purpose - to determine the currently studied mechanisms of the influence of parasitic infections transmitted during pregnancy on the immune system of the fetus and to describe the possible effects of these influence in the long term on the health of children.

Conclusions. The study of maternal parasitic infections is a rapidly developing field. Although infant mortality rates are declining, areas with endemic parasites still have the highest infant mortality rates. As antiparasitic therapy is not always curable, there is a critical need to understand the effects of maternal infection on offspring immune development. Due to the increased risk of immune alteration due to maternal inflammation and reduced passive antibody transmission, maternal parasitic infections and their mechanism of adverse immunomodulation must be uncovered to improve vaccination regimens and reduce childhood morbidity in endemic regions.

No conflict of interests was declared by the author.


Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. (2020). Maternal Immunological Adaptation During Normal Pregnancy. Frontiers in immunology. 11: 575197.; PMid:33133091 PMCid:PMC7579415

Al Malki JS, Hussien NA, Al Malki F. (2021). Maternal toxoplasmosis and the risk of childhood autism: serological and molecular small-scale studies. BMC pediatrics. 21(1): 133.; PMid:33731054 PMCid:PMC7968291

Cortés-Selva D, Gibbs L, Ready A, Ekiz HA, O'Connell R, Rajwa B, Fairfax KC. (2021). Maternal schistosomiasis impairs offspring Interleukin-4 production and B cell expansion. PLoS pathogens. 17(2): e1009260.; PMid:33524040 PMCid:PMC7877777

Figueiredo ACMG, Gomes-Filho IS, Silva RB, Pereira PPS, Mata FAFD, Lyrio AO et al. (2018). Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients. 10(5): 601.; PMid:29757207 PMCid:PMC5986481

Friedman JF, Olveda RM, Mirochnick MH, Bustinduy AL, Elliott AM. (2018). Praziquantel for the treatment of schistosomiasis during human pregnancy. Bulletin of the World Health Organization. 96(1): 59-65.; PMid:29403101 PMCid:PMC5791873

Gibbs LC, Fairfax KC. (2022). Altered Offspring Immunity in Maternal Parasitic Infections. Journal of immunology (Baltimore, Md. : 1950). 208(2): 221-226.; PMid:35017211 PMCid:PMC8769501

Harrison MS, Thorsten VR, Dudley DJ, Parker CB, Koch MA, Hogue CJR et al. (2018). Stillbirth, Inflammatory Markers, and Obesity: Results from the Stillbirth Collaborative Research Network. American journal of perinatology. 35(11): 1071-1078.; PMid:29609190 PMCid:PMC6436964

Klar K, Perchermeier S, Bhattacharjee S, Harb H, Adler T, Istvanffy R et al. (2017). Chronic schistosomiasis during pregnancy epigenetically reprograms T-cell differentiation in offspring of infected mothers. European journal of immunology. 47(5): 841-847.; PMid:28271497

Lohman-Payne B, Gabriel B, Park S, Wamalwa D, Maleche-Obimbo E, Farquhar C et al. (2018). HIV-exposed uninfected infants: elevated cord blood Interleukin 8 (IL-8) is significantly associated with maternal HIV infection and systemic IL-8 in a Kenyan cohort. Clinical and translational medicine. 7(1): 26.; PMid:30198049 PMCid:PMC6129453

Makanjuola RO, Taylor-Robinson AW. (2020). Improving Accuracy of Malaria Diagnosis in Underserved Rural and Remote Endemic Areas of Sub-Saharan Africa: A Call to Develop Multiplexing Rapid Diagnostic Tests. Scientifica: 3901409.; PMid:32185083 PMCid:PMC7060414

Malhotra I, LaBeaud AD, Morris N, McKibben M, Mungai P, Muchiri E et al. (2018). Cord Blood Antiparasite Interleukin 10 as a Risk Marker for Compromised Vaccine Immunogenicity in Early Childhood. The Journal of infectious diseases. 217(9): 1426-1434.; PMid:29390149 PMCid:PMC5894090

Mathison BA, Pritt BS. (2018). A Systematic Overview of Zoonotic Helminth Infections in North America. Laboratory medicine. 49(4): e61-e93.; PMid:30032297

McClure EM, Silver RM, Kim J, Ahmed I, Kallapur M, Ghanchi N et al. (2022). Maternal infection and stillbirth: a review. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 35(23): 4442-4450.; PMid:33233978

Msallam R, Balla J, Rathore APS, Kared H, Malleret B, Saron WAA et al. (2020). Fetal mast cells mediate postnatal allergic responses dependent on maternal IgE. Science (New York, N.Y.). 370(6519): 941-950.; PMid:33122426

Mupfasoni D, Mikhailov A, Mbabazi P, King J, Gyorkos TW, Montresor A. (2018). Estimation of the number of women of reproductive age in need of preventive chemotherapy for soil-transmitted helminth infections. PLoS neglected tropical diseases. 12(2): e0006269.; PMid:29432423 PMCid:PMC5825157

Ness TE, Agrawal V, Bedard K, Ouellette L, Erickson TA, Hotez P, Weatherhead JE. (2020). Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis. The American journal of tropical medicine and hygiene. 103(5): 1958-1968.; PMid:32840198 PMCid:PMC7646767

Olateru-Olagbegi OA, Omoruyi EC, Dada RA, Edem VF, Arinola OG. (2018). Serum Levels of Inflammatory Cytokines in Helminth Infested Pregnant Women and Cord Blood of their Babies in Relation to Pregnancy Outcome. Nigerian journal of physiological sciences : official publication of the Physiological Society of Nigeria. 33(1): 51-56.

Ondigo BN, Muok EMO, Oguso JK, Njenga SM, Kanyi HM, Ndombi EM et al. (2018). Impact of Mothers' Schistosomiasis Status During Gestation on Children's IgG Antibody Responses to Routine Vaccines 2 Years Later and Anti-Schistosome and Anti-Malarial Responses by Neonates in Western Kenya. Frontiers in immunology. 9: 1402.; PMid:29967622 PMCid:PMC6015899

Pedersen JM, Mortensen EL, Meincke RH, Petersen GL, Budtz-Jørgensen E, Brunnsgaard H et al. (2019). Maternal infections during pregnancy and offspring midlife inflammation. Maternal health, neonatology and perinatology. 5: 4.; PMid:30923624 PMCid:PMC6421709

Peyron F, L'ollivier C, Mandelbrot L, Wallon M, Piarroux R, Kieffer F et al. (2019). Maternal and Congenital Toxoplasmosis: Diagnosis and Treatment Recommendations of a French Multidisciplinary Working Group. Pathogens (Basel, Switzerland). 8(1): 24.; PMid:30781652 PMCid:PMC6470622

Santos Pd, Lorena VM, Fernandes ÉdeS, Sales IR, Nascimento WR, Gomes YdeM et al. (2016). Gestation and breastfeeding in schistosomotic mothers differently modulate the immune response of adult offspring to postnatal Schistosoma mansoni infection. Memorias do Instituto Oswaldo Cruz. 111(2): 83-92.; PMid:26872339 PMCid:PMC4750447

Sapan HB, Paturusi I, Jusuf I, Patellongi I, Massi MN, Pusponegoro AD et al. (2016). Pattern of cytokine (IL-6 and IL-10) level as inflammation and anti-inflammation mediator of multiple organ dysfunction syndrome (MODS) in polytrauma. International journal of burns and trauma. 6(2): 37-43.

Saso A, Kampmann B. (2020). Maternal Immunization: Nature Meets Nurture. Frontiers in microbiology. 11: 1499.; PMid:32849319 PMCid:PMC7396522

Tassi Yunga S, Fouda GG, Sama G, Ngu JB, Leke RGF, Taylor DW. (2018). Increased Susceptibility to Plasmodium falciparum in Infants is associated with Low, not High, Placental Malaria Parasitemia. Scientific reports. 8(1): 169.; PMid:29317740 PMCid:PMC5760570

World Health Organization. (2017). Guideline: Preventive Chemotherapy to Control Soil-Transmitted Helminth Infections in At-Risk Population Groups. Geneva: World Health Organization. PMID: 29578660.

Yang Y, Liu L, Liu B, Li Q, Wang Z, Fan S et al. (2018). Functional Defects of Regulatory T Cell Through Interleukin 10 Mediated Mechanism in the Induction of Gestational Diabetes Mellitus. DNA and cell biology. 37(3): 278-285.; PMid:29298097

Yockey LJ, Iwasaki A. (2018). Interferons and Proinflammatory Cytokines in Pregnancy and Fetal Development. Immunity. 49(3): 397-412.; PMid:30231982 PMCid:PMC6152841

Zakama AK, Ozarslan N, Gaw SL. (2020). Placental Malaria. Current tropical medicine reports. 7(4): 162-171.; PMid:32953387 PMCid:PMC7493061