Preterm Birth, An Issue of Clinics in Perinatology

Cover image

Title page

Table of Contents

Copyright

Contributors

CME Accreditation Page

Forthcoming Issues

Foreword

Preface

Solving the Puzzle of Preterm Birth

Key points

Disclosure

Recent Advances in Genomic Studies of Gestational Duration and Preterm Birth

Key points

Introduction

Gestational duration and spontaneous preterm birth: The focus of genetic studies

Genomic studies of birth timing at 3 levels

Challenges and future directions

Summary

Disclosure

Funding

Social Determinants of Premature Birth

Key points

Introduction

Maternal nativity

Weathering, allostatic load, and life-course model

Education

Adulthood residential environment

Police killings and police presence

Parental incarceration

Redlining

Early-life residential environment

Racism

Fathers

Job strain

Term infant mortality

Challenges in eliminating disparities of social determinants

Disclosure

Ambient Environment and the Epidemiology of Preterm Birth

Key points

Introduction

Select nongenetic factors

Ambient environmental factors and preterm birth risk

Genomic–environment interactions

Future directions

Disclosure

Predicting Preterm Birth Using Cell-Free Ribonucleic Acid

Key points

Introduction

Discussion

Cell-free ribonucleic acid and spontaneous preterm birth in threatened preterm labor: inflammatory and immune pathways predominate

Cell-free ribonucleic acid, preterm prelabor rupture of membranes, and prediction of chorioamnionitis

Cell-free ribonucleic acid for the prediction of spontaneous preterm birth in asymptomatic individuals: multiple potential pathways identified

Evidence suggesting inflammation precedes symptoms in spontaneous preterm birth

Evidence suggesting the role of dysfunctional myometrial quiescence in spontaneous preterm birth

Evidence for differing pathways in spontaneous preterm birth at different gestational ages: metabolic versus collagen and extracellular matrix

Summary: challenges and future directions

Predicting Preterm Birth Using Proteomics

Key points

Introduction

Methods for proteome analysis

Biological compartments

Statistical analyses

Clinical studies

Future directions

Disclosure

Funding

Estimating Gestational Age and Prediction of Preterm Birth Using Metabolomics Biomarkers

Key points

Introduction

Maternal metabolomic factors

Amniotic and cervicovaginal fluids

Postnatal metabolomic analysis of newborn peripheral blood and umbilical cord blood samples

Model development

Data preparation

External validation of North-American models

Discussion

Predicting Spontaneous Preterm Birth Using the Immunome

Key points

Introduction

Leveraging the maternal immune clock for the prediction of spontaneous preterm birth

Outlook on identifying actionable clinical biomarkers

Conclusion

Funding sources

Acknowledgments

Disclosure

Etiologically Based Functional Taxonomy of the Preterm Birth Syndrome

Key points

Introduction

The limitations of an exclusively gestational age–based preterm birth classification

Disclosure

Appendix 1. Proportion of preterm births corresponding to the etiologically based phenotypes in 2 multicountry populations (2015–2021). The variability in the distribution of PTB phenotypes across populations reflects the effect of the risk profile of the underlying populations.

Appendix 2. Standard data collection form for research and clinical use. Any livebirth or stillbirth, singleton or multiple, including terminations and congenital malformations, from 16 + 0 to 38 + 6 weeks’ gestation, may be included in this assessment. The clinical record should be the primary source of information to capture intrapartum and postpartum data, and the relevant obstetric and medical history. This should be supplemented by questioning the mother and obstetrician if the PTB has been scheduled and the reason for delivery is not clear. Finally, placental histology and, for stillbirths, an autopsy or pathology report are optimal requirements. Risk factors and mode of delivery are not included. All prenatal features should be present before initiation of delivery.