From structural modalities in perinatal medicine to the frequency of preterm birth

Abstract

Preterm birth is a global health problem that affects 11% of all live births: it remains a significant cause of death and an important cause of long-term loss of human potential among survivors all around the world. In the last decade, many developed countries have seen an increase in the rate of infants born preterm. Various theoretical and practical concepts have been discussed that aim to optimize the perinatal care of preterm infants and their mothers. These include the definition of hospitals with different levels of care, the regionalization of care, the creation of large care units with high case numbers, and a high level of expertise. This review article focuses on the connection between health care structures and different aspects of preterm birth. Furthermore, this review article highlights the fact that preterm birth is a heterogeneous syndrome with many underlying pathologies and that the causality for a large number of cases remains unexplained. There is still a significant knowledge gap concerning the actual drivers of spontaneous preterm birth, and future research particularly in parturition immunology as well as genetics of prematurity will be essential to identify new targets for therapy.

Relationship between maternal vitamin D status in the first trimester of pregnancy and maternal and neonatal outcomes: a retrospective single center study

“…Globally, 11% of newborns are preterm birth, leading to 15 million premature infants. The incidence of preterm birth is increasing in many countries, meanwhile, the survival rate of preterm babies has dramatically improved in developed countries [33,34]. Preterm birth represents a significant cause of death and can lead to serious harm to survivors all around the world [35].…”

Climate change and pregnancy complications: From hormones to the immune response

“…lasting health impairments (49,50). Among the possible pregnancy adversities, the risk for preterm birth has likely been best investigated and the majority of studies identified a risk perpetuation caused by heat, as highlighted by a current summary on the topic (51).…”

Preterm birth: pathogenesis and clinical consequences revisited

“…Deindl and Diemert highlight features of the heterogeneity of the syndrome and focus on its connection with health care structures. The authors further summarize the structural modalities required for the prevention of preterm birth by discussing various care levels of hospitals [5].…”

“…Here, the onset of chorioamnionitis is suggested to act as a first inflammatory hit. Postnatal confrontation of the prematurely born neonate with a drastically altered antigen exposure, such as hospital-specific microbes, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia can then create a second inflammatory hit [10].…”