2 2 3 1 identified five major cell types (trophoblasts, stromal cells, hofbauer cells, antigen 3 2 presenting cells and endothelial cells) with unique crosstalk at the maternal-fetal 3 3 interface. We identified seven unique trophoblast subclusters, including new subtypes 3 4 that transition into the terminal cell types, extra-villous trophoblasts and 3 5syncytiotrophoblasts. As fetal sex impacts pregnancy, we analyzed sex differences in 3 6 each cell type and identified differences in immune cell function. TGFβ1, β -estradiol, 3 7 and dihydrotestosterone emerge as upstream regulators of sexually dimorphic genes in 3 8 a cell type specific manner. Thus, the fetal contribution at the maternal-fetal interface is 3 9 cell and sex specific.4 0 Key words 4 1 Maternal-fetal interface, first trimester, ongoing pregnancy, human early pregnancy, 4 2 placenta, single cell RNA sequencing, sexual dimorphism, placenta cell types, receptor, 4 3 ligand 4 4 placental development that might impact maternal-fetal communication and contribute 6 9 to overall outcomes. 7 0 Results 7 1 7 2 RNA-sequencing of matched decidua and placenta tissue from first trimester 7 3 To identify normal early gene expression at the maternal-fetal interface, total RNA-7 4 sequencing for matched decidua (maternal) and chorionic villi (fetal placenta) was 7 5 performed. Principal component 1 shows that tissue type explains most of the difference 7 6 between samples. Principal component 2 corresponds to fetal sex (Figure S1). 7 7 RNA-sequencing identified 16,035 genes reaching threshold FPKM>1 and Z-score>0 in 7 8 decidua, placenta or both. Of these, 12,479 (77.8%) are protein-coding genes, including 7 9 3002 significantly differentially expressed genes (DEGs) with FDR<0.10 (Figure S2A, 8 0 Table S1). Over a quarter of protein-coding DEGs are tissue-unique at the maternal-8 1 fetal interface, meaning they are expressed in either decidua or placenta, but not both. 8 2 There are 2223 protein-coding DEGs upregulated in decidua compared to placenta 8 3 ("decidua-upregulated"), including 827 only expressed in decidua ("decidua-unique"). 8 4 There are 779 protein-coding DEGs upregulated in placenta compared to decidua 8 5 ("placenta-upregulated"), including 60 only expressed in placenta tissue ("placenta-8 6 unique").8 7 Receptors and ligands differentially expressed at the maternal-fetal interface 8 8To investigate maternal-fetal communication, we focused on receptor and ligand DEGs. 8 9We identified 818 receptors expressed at the maternal-fetal interface (TableS2) [7][8][9] 9 0 with 356 receptors significantly differentially expressed (FDR<0.10) between decidua 9 1 5 and placenta, including 290 decidua-upregulated receptors and 66 placenta-9 2 upregulated receptors (Figure S2B). Half of decidua-upregulated receptors are also 9 3 decidua-unique (146/290; 50.3%). The 5 decidua-unique receptors with highest fold-9 4 change over placenta are PIGR (FC = 215.3), GABRP (FC = 165.4), CDHR1 (FC = 9 5 156.5), TSPAN1 (FC = 149.1), and SCARA5 (FC = 125.4) (Table S2). Of t...