The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth

Gotsch, Francesca; Romero, Roberto; Erez, Offer; Vaisbuch, Edi; Kusanovic, Juan Pedro; Mazaki‐Tovi, Shali; Kim, Sun Kwon; Hassan, Sonia S.; Yeo, Lami

doi:10.1080/14767050902860690

Cited by 117 publications

(88 citation statements)

References 431 publications

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“…Preterm birth is a pathophysiological event, often associated with combinations of stress, hypoxia, infection, and inflammation. 1,19,36 Ligi et al 19 demonstrated that the gene profile of endothelial colony-forming cells isolated from the mononuclear cell fraction obtained from cord blood, after preterm birth, exhibits a programmed shift toward increased expression of genes with antiangiogenic functions. 10 Physiologically, this was sufficient for both the cells and the cord sera to impair angiogenesis in vitro.…”

Section: Discussionmentioning

confidence: 99%

Elevated Blood Pressure in Preterm-Born Offspring Associates With a Distinct Antiangiogenic State and Microvascular Abnormalities in Adult Life

et al. 2015

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Preterm-born individuals have elevated blood pressure. We tested the hypothesis that this associates with an enhanced antiangiogenic circulating profile and that this association is mediated by variations in capillary density. We studied 204 adults aged 25 years (range, 20–30 years), of which 102 had been followed up prospectively since very preterm birth (mean gestational age, 30.3±2.5 weeks) and 102 were born term to uncomplicated pregnancies. A panel of circulating biomarkers, including soluble endoglin and soluble fms-like tyrosine kinase-1, were compared between groups and related to perinatal history and adult cardiovascular risk. Associations with cardiovascular phenotype were studied in 90 individuals who had undergone detailed assessment of microvascular, macrovascular, and cardiac structure and function. Preterm-born individuals had elevations in soluble endoglin (5.64±1.03 versus 4.06±0.85 ng/mL; P <0.001) and soluble fms-like tyrosine kinase-1 (88.1±19.0 versus 73.0±15.3 pg/mL; P <0.001) compared with term-born individuals, proportional to elevations in resting and ambulatory blood pressure, as well as degree of prematurity ( P <0.05). Maternal hypertensive pregnancy disorder was associated with additional increases in soluble fms-like tyrosine kinase-1 ( P =0.002). Other circulating biomarkers, including those of inflammation and endothelial activation, were not related to blood pressure. There was a specific graded association between soluble endoglin and degree of functional and structural capillary rarefaction ( P =0.002 and P <0.001), and in multivariable analysis, there were capillary density–mediated associations between soluble endoglin and blood pressure. Preterm-born individuals exhibit an enhanced antiangiogenic state in adult life that is specifically related to elevations in blood pressure. The association seems to be mediated through capillary rarefaction and is independent of other cardiovascular structural and functional differences in the offspring.

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Section: Discussionmentioning

confidence: 99%

Elevated Blood Pressure in Preterm-Born Offspring Associates With a Distinct Antiangiogenic State and Microvascular Abnormalities in Adult Life

et al. 2015

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“…As preterm birth is a final deliverable of a multifactorial process, it is sometimes referred to as preterm parturition syndrome (Gotsh et al, 2009). Currently, preterm birth represents the most frequent complication of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Psychomotor development of preterm babies in the context of biomedical predictors in a Polish sample

Bidzan¹,

Bieleninik²

2014

Health Psychology Report

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Preterm birth represents the most frequent complication of pregnancy all over the world. Much research is address ed to psychomotor development of preterm infants during the initial years of their life. Many authors emphasize the role of birth weight, gestational age, and gender in deter mining the child's psychomotor development. This study adds to this knowledge as we analyzed the synergistic ef fect of biomedical predictors such as gestational age, birth weight, Apgar score, time in incubator, type of pregnancy defined based on its outcome, neonatal status immediately after delivery, infant's gender, and possessing twin sibling. Combined effects of these factors represent an important niche in the studies of the developmental psychology of pre term infants. participants and procedureThe study included 49 preterm infants born in 20082009 at the Department of Obstetrics of the Medical Universi ty of Gdańsk. The psychomotor development of preterm infants was evaluated according to the Bayley Scales of Infant and Toddler Development ® , Third Edition (BSIDIII) at a mean, noncorrected age of 33.80 months (SD = 5.16). For the purpose of the study we developed a basic model in the form of a pathway diagram, describing the cumulative influence of eight biomedical predictors on the develop ment of the infants during early childhood. resultsOur study revealed a synergistic influence of biomedical predictors on the de velopment of preterm infants with re gards to cognitive functioning (28% of variance), language skills (10% of variance), motor skills (18% of variance), fine motor skills (16% of variance), and gross motor skills (20% of variance). Moreover, we observed an independent effect of birth weight, child's gender, and final Apgar score on the psychomotor development of preterm infants. Higher birth weight was associated with higher level of cognitive func tion and fine motor skills. Male gender of a child was re flected by a higher level of cognitive function and language skills, including expressive communication. Finally, higher final Apgar scores resulted in better gross motor skills. conclusionsThis study confirmed the independent influence of bio medical predictors, such as birth weight, gender, and Apgar score, on the psychomotor development of preterm babies during early childhood. Medical factors play a crucial role in the evaluation of psychomotor development in preterm infants, and their importance should not be undervalued.key words psychomotor development; preterm infants; early child hood; biomedical predictors; BSIDIII

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“…diabetes, hypertension) and placental abnormalities; and fetal conditions such as multiple pregnancies, fetal death in utero, intrauterine growth restriction (IUGR) and congenital anomalies. 1,6,7,10 There is significant disparity between Aboriginal and nonAboriginal Australians for these outcomes: PTB (14.3% vs. 8.3%) and LBW (11.8% vs. 6.0%) 11 ; and the risk factors for example: teenage pregnancy (18.6% vs 3.0%), smoking in pregnancy (48.1% vs 10.7%) and living in remote areas (24.1% vs. 1.8%). 11,12 Aboriginal mothers are also more likely to attend antenatal care later in pregnancy and receive less antenatal visit than non-Aboriginal mothers.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia

et al. 2017

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Objective: To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women. Methods: The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004-2006 (retrospective cohort) and 2009-2011 (prospective cohort). Demographic, pregnancy characteristics, labour and birth outcomes were described. Multivariate logistic regression analysis was conducted and adjusted odds ratios were reported. Results: The preterm birth rate was 19.4%, low birthweight rate was 17.4% and small for gestational age rate was 16.3%. Risk factors for preterm birth were teenage motherhood, previous preterm birth, smoker status not recorded, inadequate antenatal visits, having pregnancy-induced hypertension, antepartum haemorrhage or placental complications. After adjusting for gender and birth gestation, the only significant risk factor for low birthweight was first time mother. The only significant risk factor for small for gestational age baby was women having their first baby. Conclusions: Rates of these events are high and have changed little over time. Some risk factors are modifiable and treatable but need early, high quality, culturally responsive women centred care delivered in the remote communities themselves. A different approach is recommended.© 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved. Statement of significance Problem or IssueAustralian Aboriginal population has significantly higher rate of preterm birth, low birthweight and small for gestational age birth, especially in rural and remote areas. What is Already KnownRisk factors of preterm births, low birthweight and small for gestational age births include social and demographic factors and medical factors. What this Paper AddsCompared to non-Aboriginal women or Aboriginal women in urban areas, similar risk factors for these events were identified in the remote dwelling Aboriginal women.

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The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth

Cited by 117 publications

References 431 publications

Elevated Blood Pressure in Preterm-Born Offspring Associates With a Distinct Antiangiogenic State and Microvascular Abnormalities in Adult Life

Elevated Blood Pressure in Preterm-Born Offspring Associates With a Distinct Antiangiogenic State and Microvascular Abnormalities in Adult Life

Psychomotor development of preterm babies in the context of biomedical predictors in a Polish sample

Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia

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