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The role of inflammation and infection in preterm birth
Roberto Romero1, Jimmy Espinoza, Luís F Gonçalves
1Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA. warfiela@mail.nih.gov
Abstract:
Inflammation has been implicated in the mechanisms responsible for preterm and term parturition, as well as fetal injury. Out of all of the suspected causes of preterm labor and delivery, infection and/or inflammation is the only pathological process for which both a firm causal link with preterm birth has been established and a molecular pathophysiology defined. Inflammation has also been implicated in the mechanism of spontaneous parturition at term. Most cases of histopathological inflammation and histological chorioamnionitis, both in preterm and term labor, are sub-clinical in nature. The isolation of bacteria in the amniotic fluid, known as microbial invasion of the amniotic cavity, is a pathological finding; the frequency of which is dependent upon the clinical presentation and gestational age. This article reviews the role of inflammation in preterm and term parturition.
Insights
Inflammation plays a key role in both preterm and term labor, with infection-induced inflammation being a primary cause of preterm birth. This review explores the molecular mechanisms and clinical implications of inflammation in parturition.
Area of Science:
- Reproductive biology
- Obstetrics
- Immunology
Background:
- Inflammation is a critical factor in both preterm and term labor.
- Infection and inflammation are the only established causes of preterm birth with defined molecular pathways.
- Sub-clinical inflammation and chorioamnionitis are common in both preterm and term labor.
Purpose of the Study:
- To review the role of inflammation in preterm and term parturition.
- To discuss the molecular pathophysiology of inflammation-induced labor.
- To examine the clinical significance of inflammation in pregnancy.
Main Methods:
- Literature review of studies on inflammation and parturition.
- Analysis of histopathological and microbiological findings in amniotic fluid.
- Synthesis of current knowledge on the molecular mechanisms of labor.
Main Results:
- Inflammation is a common pathway for both preterm and term birth.
- Microbial invasion of the amniotic cavity is a significant pathological finding.
- Sub-clinical inflammation is prevalent and linked to parturition.
Conclusions:
- Inflammation is a central mechanism in parturition, particularly in preterm birth.
- Understanding inflammation's role is crucial for managing preterm labor and fetal injury.
- Further research into sub-clinical inflammation and microbial invasion is warranted.
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