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Updated: Mar 6, 2026
08:19
Isolation of Leukocytes from the Human Maternal-fetal Interface
Published on: May 21, 2015
16.8K
Hematologic disorders in pregnancy: the role of the complement system.
Charlotte M Story1, Shruti Chaturvedi1, Gloria F Gerber1
1Department of Medicine, Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Expert Review of Hematology
|March 5, 2026
Summary
Complement dysregulation in pregnancy can cause severe maternal and fetal issues. Complement inhibitors show promise for treating paroxysmal nocturnal hemoglobinuria (PNH) and thrombotic microangiopathies (TMA), with urgent needs for further research in other conditions.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Maternal-Fetal Medicine
Background:
- Complement homeostasis is critical for healthy pregnancy.
- Excessive complement activation can lead to severe maternal and fetal complications.
- This review focuses on complement dysregulation in pregnancy.
Purpose of the Study:
- To review changes in complement regulation during pregnancy.
- To discuss management of paroxysmal nocturnal hemoglobinuria (PNH), thrombotic microangiopathies (TMA), and antiphospholipid syndrome (APS) in pregnancy.
- To explore the role of complement in severe hypertensive disorders of pregnancy.
Main Methods:
- Expert narrative review based on subject-matter expertise.
- Summarized and critiqued key studies and concepts.
- Prioritized review of clinical trials and case reports on complement inhibitors in pregnancy.
Main Results:
- Complement inhibitors have improved outcomes in PNH and TMA during pregnancy.
- Evidence is emerging for complement's role in hypertensive disorders of pregnancy.
- Management considerations for PNH, TMA, and APS in pregnancy were reviewed.
Conclusions:
- Functional biomarkers for complement activity in pregnancy are needed.
- Prompt use metrics for complement inhibitors in TMAs require definition.
- Clinical trials for complement inhibition in obstetric APS and hypertensive disorders are urgently required.
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