Prevention of preterm birth: Harnessing science to address the global epidemic

Rubens, Craig E.; Sadovsky, Yoel; Muglia, Louis J.; Gravett, Michael G.; Lackritz, Eve; Gravett, Courtney

doi:10.1126/scitranslmed.3009871

Cited by 144 publications

(123 citation statements)

References 106 publications

(93 reference statements)

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“…Teenage pregnancy, also a risk factor for prematurity, has instead been decreasing over the past decade (Hamilton et al 2015; The March of Dimes Data Book for Policy Makers 2012). However, it is very critical to remember that both very preterm infants (VPI) and extreme preterm infants (EPI) are heterogeneous, and our understanding of causal pathways that lead to successful interventions is at an early scientific stage (Rubens et al 2014). For example, the same factors that create the biological risk in the mothers for prematurity may be the same factors that influence the inflammatory, hormonal, and neurochemical regulators that influence the mothers' caregiving capacity once their premature infant is born.…”

Section: Introductionmentioning

confidence: 99%

Life Course Health Development Outcomes After Prematurity: Developing a Community, Clinical, and Translational Research Agenda to Optimize Health, Behavior, and Functioning

Msall

Sobotka

Dmowska

et al. 2017

Handbook of Life Course Health Development

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Section: Introductionmentioning

confidence: 99%

Life Course Health Development Outcomes After Prematurity: Developing a Community, Clinical, and Translational Research Agenda to Optimize Health, Behavior, and Functioning

Msall

Sobotka

Dmowska

et al. 2017

Handbook of Life Course Health Development

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“…Preterm birth (PTB) affects 11.1% of all pregnancies worldwide [1], in which 70% are spontaneous [2] and present multifactorial etiology, as infection or inflammation, uteroplacental ischaemia or haemorrhage, uterine overdistension or stress [3] and maternal risk factors as previous PTB [4]. However, there are abundant evidences that the infection/inflammation is strongly related to this syndrome, mostly linked to ascending microorganisms from the lower genital tract [5] [6], in which is present in nearly 50% of PTB and 70% of preterm premature rupture of membranes (pPROM) [7].…”

Section: Introductionmentioning

confidence: 99%

Human Beta Defensins 1, 2 and 3 Produced by Amniochorion Membranes Is Similar in Term and Preterm Delivery

Noda-Nicolau¹,

Polettini²,

Marconi³

et al. 2017

OJOG

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Amniochorion membranes were collected from 25 pregnant women at preterm labor, in the presence or not of Preterm Premature Rupture of Membranes (PPROM) and 27 pregnant women at term in the presence at labor, in order to quantify the expression and to evaluate the immunoreactivity of human beta defensins (HBD)1, HBD2, HBD3 and HBD4 in amniochorion membranes from pregnancies complicated by spontaneous prematurity. The HBDs were evaluated by immunohistochemistry, real time quantitative PCR and ELISA. Statistical analyses were performed using Chi-squared and Mann Whitney tests. There was no significant difference in HBDs expression between study and

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“…In high income countries, about one third of pregnancies are interrupted for maternal or fetal indications, such as preeclampsia and diabetes [4,5]. About 70% of PTBs follow spontaneous labor, with membranes either intact or prematurely ruptured.…”

mentioning

confidence: 99%

“…About 70% of PTBs follow spontaneous labor, with membranes either intact or prematurely ruptured. PTBs can also be subdivided based on gestational age, into extreme preterm (<28 weeks, accounting for 5%), severe preterm (28-31 weeks, 20%), moderate preterm (32-33 weeks, 20%) and late preterm (34-36 weeks, 60-70%] [5].…”

mentioning

confidence: 99%

Preterm Birth: An Inflammatory Syndrome, Not Just A Myometrial Disorder

Mai-Vo¹,

Nadeau-Vallée²,

Beaudry-Richard³

2017

UOJM

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Preterm birth (PTB) is the leading cause of neonatal mortality and morbidity. Although the severity of neonatal outcomes is inversely correlated with gestational age, all PTBs can lead to potentially life-threatening neonatal outcomes and major lifelong health complications. Because advances in neonatal care have substantially decreased neonatal mortality, the incidence of PTB and its complications is unabatedly rising. PTB currently affects more than 10% of births worldwide, with similar numbers in developed countries. Correspondingly, improving neonatal outcome is a key objective of the World Health Organization. The recently approved (in Europe) tocolytics drug, Atosiban, used to prolong preterm gestation, has not been shown to improve neonatal outcome, nor have other tocolytic agents used in clinic. Thus, PTB remains an unmet medical need. Recent evidence shows that most, if not all, PTBs are associated with (overt or occult) inflammatory processes in gestational tissues, independent of infection. Proinflammatory cytokines are produced from maternal and fetal cells in response to sterile or infectious stressors. These seem to orchestrate a multi-tissue response including myometrial contractility, cervical ripening, and weakening/rupture of fetal membranes, leading to the onset of preterm labor. This integrated system might have been conserved through mammalian evolution due to increased maternal and/or fetal survival when gestation is terminated in specific settings, such as infection. Hence, inflammation may be a common pathway to the numerous aetiologies of PTB. Most importantly, recent evidence suggests that inflammation is transmitted to the fetus, thereby inducing organ injuries that may underlie the development of major neonatal diseases. Targeting inflammation prenatally instead of myometrial contraction could be a more successful and safe approach for the management of PTB, as suggested by recent animal studies. ABSTRACTLa naissance prématurée est la principale cause de mortalité et de morbidité néonatale. Bien que la sévérité des issus néonataux soit inversement corrélée avec l'âge gestationnel à la naissance, toutes les naissances prématurées peuvent mener à des issus néonataux potentiellement mortels et à des complications avec répercussions s'échelonnant sur toute la vie. Étant donné que la mortalité néonatale a considérablement diminuée avec les récentes avancées en néonatalogie, l'incidence de la naissance préma-turée et de ses complications sont en hausse. La naissance prématurée affecte présentement plus de 10% des naissances à travers le monde, avec des taux similaires dans les pays développés. Conséquemment, d'améliorer l'issu néonatal est un objectif clé de l'Organisation Mondiale de la Santé. Le tocolytique Atosiban récemment approuvé (en Europe) pour prolonger les gestations pré-maturées n'a pas démontré d'efficacité pour améliorer les issus néonataux, tout comme les autres tocolytiques utilisés en clinique, et la naissance prématurée demeure un besoin médical non-atteint. Des données r...

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Prevention of preterm birth: Harnessing science to address the global epidemic

Abstract: This review summarizes the state of research on the causes of preterm birth, potential targets for prevention, and translational challenges and opportunities.

Cited by 144 publications

References 106 publications

Life Course Health Development Outcomes After Prematurity: Developing a Community, Clinical, and Translational Research Agenda to Optimize Health, Behavior, and Functioning

Life Course Health Development Outcomes After Prematurity: Developing a Community, Clinical, and Translational Research Agenda to Optimize Health, Behavior, and Functioning

Human Beta Defensins 1, 2 and 3 Produced by Amniochorion Membranes Is Similar in Term and Preterm Delivery

Preterm Birth: An Inflammatory Syndrome, Not Just A Myometrial Disorder

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