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[Preterm labor: pathophysiology, risk factors and outcomes]
1INSERM U149, Unité de Recherches Epidémiologiques en Santé Périnatale et Santé des Femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif Cedex, France. Ancel@vjf.inserm.fr
Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|November 28, 2002
Summary
Preterm labor (PL) affects 50% of pregnancies, leading to premature birth. While risk factors and triggers are known, PL itself may not increase neonatal death outside of infection.
Area of Science:
- Obstetrics and Gynecology
- Neonatology
- Reproductive Medicine
Context:
- Preterm labor (PL) is a primary cause for pregnancy-related hospital admissions.
- Approximately 50% of pregnant women receive a PL diagnosis.
- 7% of neonates are born prematurely, with one-third of these births occurring with intact membranes.
Purpose:
- To review established risk factors for preterm labor with intact membranes.
- To explore potential triggers such as intrauterine infection and hormonal axes.
- To assess the impact of PL on neonatal outcomes, particularly in the context of infection.
Summary:
- Established risk factors for PL with intact membranes include prior preterm delivery, young maternal age, and low socioeconomic status.
- Associated conditions include intrauterine infection, placental abruption, and uterine/cervical anomalies.
- While cytokines and the fetal HPA axis may trigger PL, conclusive data are limited. Intrauterine infection poses a risk for neonatal infection, cerebral lesions, and cerebral palsy.
Impact:
- Understanding PL triggers and risk factors is crucial for prevention strategies.
- Identifying PL may not significantly increase neonatal mortality or morbidity unless complicated by perinatal infection.
- Further research is needed to elucidate the precise mechanisms triggering preterm labor and its associated neonatal risks.