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Table 1 Commonly recognized etiologies and pathways leading to spontaneous preterm birth

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