Preterm Labor
Preterm birth is associated with 5-18% of pregnancies and is a leading cause of infant morbidity and mortality.
Spontaneous preterm labor, a syndrome caused by multiple pathologic processes, leads to 70% of preterm births. The prevention and treatment of preterm labor have been a long-standing challenge.
Preterm birth is defined as birth prior to 37 weeks of gestation. It is the leading cause of neonatal death and the second cause of childhood death below the age of 5 years. Approximately 15 million preterm neonates are born every year, and the highest rates occur in Africa and North America. Neonates born preterm are at an increased risk of short-term complications attributed to immaturity of multiple organ systems, as well as neurodevelopmental disorders, such as cerebral palsy, intellectual disabilities, and vision/hearing impairments. Preterm birth is a leading cause of disability-adjusted life years, the number of years lost due to ill health, disability or early death, and the annual cost in the United States is at least $26.2 billion per year and climbing.
Two-thirds of preterm births occur after the spontaneous onset of labor, whereas the remainder is medically indicated due to maternal or fetal complications, such as preeclampsia or intrauterine growth restriction. Herein we propose that preterm labor is a syndrome caused by multiple pathologic processes, summarize important gains in the prevention of spontaneous preterm birth, and highlight promising areas for investigation.
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