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. 2021 Apr 26;14(5):991–1005. doi: 10.1038/s41385-020-00374-3

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Several aspects of the pathogenesis of a given infection can influence pregnancy outcomes: (i) tissue immunity to pathogen invasion at the fetal-maternal interface, (ii) in utero vertical transmission, and (iii) systemic immune response to infection. Both systemic and local tissue immune responses can be triggered by microbial invasion and may lead to pathogen elimination, and thus protect both mother and fetus. However, the activation of the immune system and the infection per se can lead to placental tissue damage, which might facilitate in utero vertical transmission and/or placental failure leading in turn to adverse pregnancy outcomes.