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These changes affect all organ systems and are designed both to protect the fetus and to minimize risk to the mother. One of the most prominent adaptations involves the immune system. The semi\u2010allogenic fetoplacental unit has non\u2010self components and must be protected against attack from the host. This requires both attenuation of adaptive immunity and protection from innate immune defense mechanisms. One of the key innate immune players is complement, and it is important that the fetoplacental unit is not identified as non\u2010self and subjected to complement attack. Adaptation of the complement response must, however, be managed in such a way that maternal protection against infection is not compromised. As the complement system also plays a significant facilitating role in many of the stages of a normal pregnancy, it is also important that any necessary adaptation to accommodate the semi\u2010allogenic aspects of the fetoplacental unit does not compromise this. In this review, both the physiological role of the alternative pathway of complement in facilitating a normal pregnancy, and its detrimental participation in pregnancy\u2010specific disorders, are discussed.<\/jats:p>","DOI":"10.1111\/imr.13169","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T11:00:17Z","timestamp":1668510017000},"page":"298-319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Alternative pathway activation in pregnancy, a measured amount \u201ccomplements\u201d a successful pregnancy, too much results in adverse events"],"prefix":"10.1111","volume":"313","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-0836","authenticated-orcid":false,"given":"Kate","family":"Smith\u2010Jackson","sequence":"first","affiliation":[{"name":"Complement Therapeutics Research Group, Translational and Clinical Research Institute, Faculty of Medical Science Newcastle 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