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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