From: Global report on preterm birth and stillbirth (2 of 7): discovery science
Pathway | Examples | Mechanistic Effectors | Gestational Age When Predominant |
---|---|---|---|
Infection or Inflammation | Intrauterine Lower genital tract Systemic | Pro-inflammatory cytokine/ prostaglandin cascade Matrix metalloproteinases | Early preterm birth (24-32 weeks) |
Decidual Hemorrhage | Thrombophilias, Placental abruption Autoantibody syndromes | Thrombin Matrix metalloproteinases | Early or late preterm birth |
Maternal/Fetal HPA Activation | Stress | Maternal/Fetal HPA activation Placental CRH Estrogens Immune modulation | Late preterm birth (32-36 weeks) |
Pathologic Uterine Overdistension | Multifetal gestation Polyhydramnios | Expression of gap junctions proteins Prostaglandins Oxytocin receptors | Late preterm birth |