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===Immune system=== As a prerequisite for a successful pregnancy, the [[immune system]] undergoes changes so that the mother's body will not reject the fetus.<ref name=":2">{{Cite journal | last = Reinhard | first=G. | last2 = Noll | first2 = A. | last3 = Schlebusch | first3 = H. | last4 = Mallmann | first4 = P. | last5 = Ruecker | first5 = A.V. | date = 1998-04-28 | title = Shifts in the TH1/TH2 balance during human pregnancy correlate with apoptotic changes|url=https://www.ncbi.nlm.nih.gov/pubmed/9588218|journal=Biochemical and Biophysical Research Communications|volume=245|issue=3 | pages = 933β938|doi=10.1006/bbrc.1998.8549|issn=0006-291X|pmid=9588218}}</ref> To do so, there is a general shift of the immune system from the a pro-inflammatory state (Th1) to an anti-inflammatory state (Th2) during pregnancy. Helper T cells (Th) of the immune system are divided into two main categories, Th1 and Th2, that have opposite functional activity. An immune response can be categorized as a Th1 response (pro-inflammatory, usually in response to pathogens or injury) or a Th2 response (anti-inflammatory, can be used to down-regulate the Th1 state). While both Th1 and Th2 responses are at play, the immune system tends to be dominated by one or the other depending on the Th1/Th2 balance.<ref>{{Cite journal | last = Kidd | first=Parris | date = Aug 2003 | title = Th1/Th2 balance: the hypothesis, its limitations, and implications for health and disease|url=https://www.ncbi.nlm.nih.gov/pubmed/12946237|journal=Alternative Medicine Review: A Journal of Clinical Therapeutic|volume=8|issue=3|pages=223β246|issn=1089-5159|pmid=12946237}}</ref> One study has shown that T cells from pregnant women produce less Th1 cytokines and more Th2 cytokines, indicating a general shift toward the Th2 anti-inflammatory state. Additionally, levels of regulatory T cells [[Treg|(Tregs)]], progesterone, and estrogen increase during pregnancy, which have anti-inflammatory properties.<ref>{{Cite journal | last = Munoz-Suano | first = Alba | last2 = Hamilton | first2 = Alexander B. | last3 = Betz | first3 = Alexander G. | date = May 2011 | title = Gimme shelter: the immune system during pregnancy|url=http://www.ncbi.nlm.nih.gov/pubmed/21488887|journal=Immunological Reviews|volume=241|issue=1|pages=20β38|doi=10.1111/j.1600-065X.2011.01002.x|issn=1600-065X|pmid=21488887}}</ref> In contrast, the T cells in women with recurrent spontaneous abortions produce normal, non-pregnancy levels of Th1 and Th2 cytokines, indicating a Th1 pro-inflammatory state in unsuccessful pregnancies.<ref name=":2" /> In this way, many spontaneous abortions are similar to organ transplant rejections; a Th2 state is required for successful pregnancies and organ transplants, and failed organ transplants usually occur in people who remain in a Th1 dominant state.<ref name=":2" />
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