JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (10): 1371-1377.doi: 10.3969/j.issn.1674-8115.2021.10.016

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Research progress in immune pathogenesis of unexplained recurrent spontaneous abortion

Wen-xin BAI(), Ai-min ZHAO()   

  1. Department of Gynecology and Obstetrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2021-10-28 Published:2021-08-13
  • Contact: Ai-min ZHAO;
  • Supported by:
    National Natural Science Foundation of China(81871179)


Recurrent spontaneous abortion (RSA) is one of the most common pregnancy complications in gynecology and obstetrics. The etiology of RSA is complex and diverse. In addition to the known causes such as autoimmune abnormalities, thrombophilia, endocrine factors, anatomical abnormalities of female genital tract, chromosome abnormalities of husband and wife, and fetal chromosome or gene abnormalities, there are still 40%?50% of patients cannot find the exact cause, which is called unexplained recurrent spontaneous abortion (URSA). Due to the unknown etiology, it also brings great trouble to develop effective therapy. In recent years, with the development of reproductive immunology, more and more evidences suggest that the occurrence of URSA is related to the imbalance of maternal-fetal immune mechanisms, which also brings hope for the development of therapeutic strategies for URSA. This article reviews the concept of maternal-fetal interface and maternal-fetal immune tolerance, the mechanism of formation and imbalance of maternal-fetal immune tolerance, and the research progress of immune pathogenesis of URSA.

Key words: unexplained recurrent spontaneous abortion, maternal-fetal interface, maternal-fetal immune tolerance

CLC Number: