Embodied Immunity: Place, Inequality, and Reproductive Outcomes in Two US Communities

Immune dysregulation has been linked to adverse reproductive outcomes, yet its biocultural determinants remain underexplored. This study examines how environmental inequality and embodied life history factors intersect to shape pregnancy loss among women in two socio-environmentally distinct, low-resource US communities. We hypothesized that indicators of immune activation and reproductive history would be associated with increased likelihood of pregnancy loss. Data were collected from 112 women (ages 22-84) with prior pregnancies residing in rural Mississippi and periurban Illinois. Surveys captured demographic, health, and reproductive histories, and dried blood spot samples were analyzed for C-reactive protein (CRP), immunoglobulin E (IgE), and immunoglobulin G (IgG) concentrations. 32.6% of participants self-reported at least one pregnancy loss, with higher rates in Illinois than in Mississippi (41.2% vs. 22.0%). After excluding biomarker values suggestive of acute inflammation (> 10 mg/L CRP), none of the immune markers independently predicted pregnancy loss. As biomarkers were measured cross-sectionally, they are best interpreted as indicators of immune ecology, reflecting both current infections and exposures as well as long-term environmental inequality, rather than acute determinants of reproductive outcomes. In adjusted models, only number of pregnancies significantly predicted loss (p < 0.01). These findings suggest that pregnancy loss in this sample may be better explained by the cumulative embodiment of environmental and social conditions that are not being captured by isolated immune biomarkers.