Journal
SCIENCE
Volume 345, Issue 6198, Pages 760-765Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.1251816
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Funding
- Division of Intramural Research of the Eunice Kennedy Shriver NICHD, NIH/Department of Health and Human Services
- NIH [HD068524, DA06668]
- March of Dimes [21-FY12-127, 22-FY14-470]
- [R37 HD076253]
- [U54 HD055764]
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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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