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[0] Moran, Thomas [1] Immune Response to Virus Infection During Pregnancy [2] Mt. Sinai School of Medicine [3] NO1-AI-50028* [4] 
Pregnancy is a uniquely advantageous system to evaluate the consequences of immunosuppression in that a woman returns to normal immune function following its resolution. Therefore, individual level correlates of immune function, such as vaccination status, allergies, medical history, and background genetic characteristics, become irrelevant when she acts as her own control. Moreover, altered immunity during pregnancy may have consequences on the efficacy of vaccines or immunotherapeutic treatments. Susceptibility to infection may also be affected at specific times during pregnancy. Levels of circulating estrogen, progesterone, and other placental hormones/peptides are suspected to be critical factors that modulate the adaptive changes observed in maternal systemic immunity. Thus, individuals in high-risk periods may need to be treated differently. We propose to enroll 50-75 women in a prospective cohort study to examine the longitudinal changes in immunity over the course of pregnancy, the post-partum lactation period, and post-lactation normal period. As such, each woman will act as her own control, allowing us to characterize the nature, extent and correlates of immune competence during the pregnancy and neonatal period. The study will determine whether the different trimesters of pregnancy, characterized by unique hormonal environments, are associated with (a) identifiable, discrete changes in maternal systemic immunity and/or (b) recognizable alterations in susceptibility to select bio-defense pathogens and/or (c) differential responses to influenza vaccination
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