Maternal-Fetal Medicine (Jul 2020)
Preterm Birth, From the Biological Knowledges to the Prevention: An Overview
Abstract
Abstract. The time of birth is a critical determinant of perinatal and long-term outcomes, and even trans-generational effects. Preterm birth is still the leading cause of infant mortality and morbidity. Unfortunately, rates of preterm birth remain high worldwide. Preterm parturition is a complex syndrome, which can be induced by several factors such as infection, cervical pathology, uterine overdistension, progesterone deficiency, vascular alterations (utero-placental ischemia, decidual hemorrhage), maternal and fetal stress, allograft reaction, allergic phenomena, and probably other several unknown factors. The mechanisms responsible for early labor activation have been partially identified and involve receptors, chemokines, and inflammatory cytokines. It is very useful to understand the cellular and biochemical pathways responsible for preterm labor activation to identify, treat, and prevent negative outcome in a timely manner. Researchers and clinicians play a key role in improving biochemical knowledge on preterm delivery, identifying risk factors, and applying multilevel preventive strategies.