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A Data-Driven Approach to Quantifying Immune States in Sepsis
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Published on: February 7, 2025

Immunology of pregnancy and sepsis: shared and specific pathways guiding future precision care

Harindra E Amarasinghe1, Julian C Knight2, Marian Knight3

  • 1Chinese Academy of Medical Sciences Oxford Institute, University of Oxford, Oxford, UK; National Perinatal Epidemiology Unit, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK; Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Ebiomedicine
|July 11, 2026
PubMed

Maternal sepsis remains a leading cause of preventable death globally, yet its underlying biology within the context of pregnancy is poorly understood. This review examines the extent to which pregnancy and sepsis share physiological, immunological, and regulatory pathways. We propose a unifying model for maternal sepsis that integrates immune, transcriptomic, epigenetic, and metabolic frameworks to advance a precision medicine approach, restoring immune equilibrium, controlling pathological inflammation while preserving pregnancy-specific adaptations. We address key knowledge gaps in current precision maternal care in sepsis and discuss the potential and limitations of emerging approaches supporting individualised risk assessment, trimester-specific immune monitoring, and targeted recovery interventions. Pregnancy itself serves as a model for natural immunological equilibrium, where tolerance and defence are finely balanced, offering broader insights for sepsis management beyond obstetrics. Translating these insights into equitable, pregnancy-compatible therapeutic strategies is an exciting opportunity to reduce the global burden of maternal sepsis and improve outcome.

Keywords:
Future directionsMaternal sepsisPrecision medicinePregnancySepsisShared

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