Role of innate factors of fetal immunity and maternal microbiome and infections in the formation of perinatal pathology of newborns

Development of molecular genetics and cellular immunology has fundamentally changed the understanding of the relationship between mother and child during pregnancy. For a successful pregnancy, it is necessary for the mother's immune system to recognize and accept the semi-allogeneic fetus, ensuring effective penetration of fetal trophoblasts into the uterine body and protecting the fetus from external pathogens and the mother's microbiota. This is achieved through the exchange of immune and hematopoietic stem cells of the mother and the child with the formation of a cellular chimera called feto-maternal microchimerism as well as vice versa, the formation of the innate immunity of the fetus, ensuring its tolerance to the microbiota and chronic infections of the mother. Innate immunity and hematopoiesis are formed from the cells of the yolk sac mesoderm and extraembryonic mesenchymal tissue due to granule-macrophage-like precursors and pluripotent erythroid cells. During the first trimester of pregnancy and prior to the formation of the thymus and bone marrow hematopoiesis and, therefore, the implementation of the adaptive immune response, the fetus has a formed innate immune defense and cellular control over the biology of its own development represented by neutrophils, eosinophils, basophils, monocytes, macrophages, dendritic cells and the five types of innate lymphoid cells. Innate immune cells are activated by molecular pattern molecules mediated by pattern recognition receptors which provides rapid protection against microbiota pathogens and chronic infections and helps get rid of dying and/or damaged innate cells. Analysis of the interaction between the microbiome, acute and chronic maternal infections, development and functioning of innate lymphoid cells in the fetal and neonatal period is of a great clinical importance aiming at detailing the pathogenesis and developing pathogenetically based therapy, prevention and treatment of eclampsia, pregnancy complications, such as premature birth and other problems associated with placental abruption, bronchopulmonary dysplasia, necrotizing enterocolitis, pneumonia and sepsis in premature and newborn infants. Author presents an analysis of the recent data on the role of innate immunity in terms of evidence-based links with perinatal disorders in newborns and proposals for planning of further scientific research in this important area.