Worldwide, deaths from adverse pregnancy outcomes of preterm birth (PTB) and stillbirth (SB) represent the longest, deadliest pandemic in human history. Neonatal infection (e.g. sepsis) is the main cause of death for children under 5 years; with premature babies being especially susceptible to infection. While the final common pathway for SB, PTB and neonatal sepsis is associated with aberrant inflammation in the maternal-fetal dyad, lack of insight into the underlying mechanisms has hampered identification of effective upstream preventative or downstream therapeutic interventions. A focus on immune regulation during pregnancy and in early life is thus urgently warranted. This interdisciplinary Keystone Conference on maternal-fetal-newborn immunity brings together the world’s experts across maternal, fetal and neonatal/infant immunity for the first time with the following goals:

1. Identify the most important gaps in knowledge as well as experimental and analytical technology to answer the question: What is the problem? What is needed to tackle it?
2. Craft the conceptual framework around the immunology of the maternal-fetal-newborn dyad to answer: How does the problem/s and possible solutions fit into the broader areas of immune -tolerance, -resilience, -resistance? How will the work proposed shift current paradigms?
3. Initiate a global consortium to tackle adverse pregnancy outcomes on the necessary global scale. This is to answer: What does it take to recognize the maternal-fetal-newborn unit as one biological unit? What does it take to make this a global priority?