{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:19:51Z","timestamp":1778566791542,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Fetal surgery (FS) for spina bifida (SB) repair improves infant outcomes; however, spontaneous preterm birth (sPTB) is common. We aimed to evaluate maternal and fetal immune responses following FS for SB repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Pregnant participants undergoing fetoscopic SB repair at 24\u201326\u00a0weeks of gestational age (GA) were prospectively recruited and compared to GA matched low\u2010risk controls. Blood samples were collected at baseline, 2\u2010week post\u2010surgery (POD14), and delivery. Cytokine analysis, flow cytometry, and T cell receptor (TCR) sequencing were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>sPTB occurred in 5\/6 of the FS group (0\/6 of controls). Maternal blood in the FS group demonstrated increased alpha\u2010fetoprotein (AFP) and anti\u2010inflammatory IL\u20101RA at baseline and POD14, increased pro\u2010inflammatory IL\u20108 only post\u2010operatively, and elevated growth factors throughout. T cell phenotypes following FS revealed reduced TH17 frequency but increased activation receptors on cytotoxic T cells. At delivery, the FS cohort had reduced Th2 and Th17 helper T cells and CD4+ memory T cells, but CD8 T cells still showed increased activation. No TCR expansion was detected post\u2010surgery, suggesting antigen\u2010independent activation. Cord blood in FS repaired neonates had increased AFP, IL\u20108, IL\u20101RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Systemic immune changes following FS, particularly T cell maturation and activation, were observed. Further characterization of these mechanisms may help predict and prevent surgery\u2010induced PTB, improving outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70021","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T02:00:46Z","timestamp":1762394446000},"page":"1816-1826","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of Maternal and Fetal Immunity Following\n                    <i>in Utero<\/i>\n                    Spina Bifida Repair and Surgery\u2010Induced Preterm Birth"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5833-4326","authenticated-orcid":false,"given":"Katherine","family":"Martinez Carmona","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra 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