Finger-prick transcriptomic profiling in northern Nigeria reveals a muted maternal systemic response in stillbirth

Abstract Inflammation is implicated in placental dysfunction leading to stillbirth, yet evidence of a systemic immune response during parturition remains unclear. Here, we present the first transcriptomic analysis of maternal systemic responses associated with stillbirth, using a minimally invasive finger-prick method for whole blood collection in labouring women in northern Nigeria. This approach facilitated participant recruitment with minimal disruption to care and provided high-quality RNA for transcriptomic profiling. Contrary to expectations, no major differences were observed in systemic immune states between propensity-matched live births and stillbirths. These findings suggest several possibilities, including the dominance of a parturition response masking an underlying immune state, physical protective barriers, or placental tolerance mechanisms. This study offers novel insights into maternal systemic immune health during stillbirth and highlights the need for further research. It also contributes to the broader “Stillbirths in Kano” initiative, aimed at reducing stillbirth rates through enhanced prenatal care.