Preterm labor: One syndrome, many causes

Romero, Roberto; Dey, Sudhansu K.; Fisher, Susan J.

doi:10.1126/science.1251816

Cited by 1,984Preterm Birth and ChorioamnionitisReproductive System and PregnancyMaternal and Perinatal Health Interventions

Preterm labor: One syndrome, many causes

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Romero, Roberto, Dey, Sudhansu K., Fisher, Susan J.·2014·Science

DOI 10.1126/science.1251816PMC PMC4191866

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Abstract

Preterm birth is associated with 5 to 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 the treatment of preterm labor have been long-standing challenges. We summarize the current understanding of the mechanisms of disease implicated in this condition and review advances relevant to intra-amniotic infection, decidual senescence, and breakdown of maternal-fetal tolerance. The success of progestogen treatment to prevent preterm birth in a subset of patients at risk is a cause for optimism. Solving the mystery of preterm labor, which compromises the health of future generations, is a formidable scientific challenge worthy of investment.

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PTB has a complex aetiology.
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[5]Behrman RE Butler AS Preterm Birth: Causes, Consequences, and Prevention 2007 Washington (DC) 20669423
[24]Romero R Hassan S Gajer P Tarca AL Microbiome 2014 PMC4066267 24987521
[69]Gravett MG Novy MJ Rosenfeld RG Reddy AP JAMA: the journal of the American Medical Association 2004 292 462

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Authors: Romero, R., Dey, S. K., & Fisher, S. J.
Affiliations: National Institutes of Health (US)
Cincinnati Children's Hospital Medical Center (US)
University of California, San Francisco (US)
ORCID: Romero, Roberto
Dey, Sudhansu K.
Fisher, Susan J.
Venue: Science
Publisher: American Association for the Advancement of Science (AAAS)
Published: 2014-08-15
Volume: 345
Issue: 6198
Pages: 760-765
ISSN: 0036-8075 (ISSN-L)
1095-9203
DOI: 10.1126/science.1251816
PMC: PMC4191866
OpenAlex: W2010101647
Cited by: 1,984
References: 73
Citations by year: 2026: 138 · 2025: 151 · 2024: 165 · 2023: 215 · 2022: 211 · 2021: 227 · 2020: 192 · 2019: 151 · 2018: 141 · 2017: 142 · 2016: 121 · 2015: 112 · 2014: 12 · 2013: 2
FWCI: 17.22
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Science (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: U.S. Department of Health and Human Services
March of Dimes Foundation
National Institutes of Health (DA06668)
National Institute on Drug Abuse (DA06668, R01DA006668, R37DA006668)
National Institute of Child Health and Human Development (HD068524)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD055764, R37HD076253, P50HD055764, HD055764, HD068524, R01HD068524, ZIAHD002400)
NHLBI Division of Intramural Research
Topics: Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: preterm labor, preterm birth, spontaneous preterm labor, chorioamnionitis, maternal-fetal immune tolerance, progestin therapy, preterm birth prevention, preterm birth treatment
MeSH terms: Decidua, Female, Fetus, Humans, Immune Tolerance, Infections, Inflammation, Obstetric Labor, Premature, Placenta, Pregnancy, Syndrome, Vascular Diseases

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Preterm labor: One syndrome, many causes

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