Preterm birth: pathogenesis and clinical consequences revisited
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INTRODUCTION
Preterm birth: pathogenesis and clinical consequences revisited Anke Diemert 1 & Petra Clara Arck 1 Published online: 22 September 2020 # The Author(s) 2020
Preterm birth, defined as delivery at less than 37 weeks’ gestation, is one of the most pressing clinical problems in obstetrics worldwide [1]. Despite the significant medical advances accomplished over the last few decades, approximately 15 million babies are still born too soon, with alarming rates of rising prematurity in most countries [2, 3]. Preterm birth is not only the major contributor to neonatal morbidity and mortality globally, it also accounts for the increasing numbers of intergenerational non-communicable diseases. It is estimated that 106 million disability-adjusted life years are lost annually to preterm birth. Thus, preterm birth is a high priority public health problem and it is essential to reduce the rate of preterm birth in order to achieve the health-related Millennium Developmental goals set forth by the WHO in 2000 [4]. These goals can only be achieved if understanding of the pathogenesis of the multifactorial nature of preterm birth improves. Hence, a significant number of research endeavors aim to unearth markers and mediators accounting for the onset of preterm birth. In this special issue, we have compiled a comprehensive update on clinical, socioeconomic, and pathophysiological aspects currently known to be involved in preterm birth. Deindl and Diemert highlight features of the heterogeneity of the syndrome and focus on its connection with health care structures. The authors further summarize the structural modalities required for the prevention of preterm birth by discussing various care levels of hospitals [5]. To date, the accurate prediction and subsequently prevention of preterm birth is not yet within reach. Clearly, such predictionbased prevention of preterm birth is a highly desired goal and, This article is a contribution to the special issue on Preterm birth: Pathogenesis and clinical consequences revisited - Guest Editors: Anke Diemert and Petra Arck * Anke Diemert [email protected] * Petra Clara Arck [email protected] 1
Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
thus, pursued by a number of researcher and clinicians. Pizzella et al. put forward evolving techniques to predict preterm birth, focusing on cervical imaging technologies. Currently used and emerging imaging techniques such as brightness-mode ultrasound, Raman spectroscopy, and photoacoustic endoscopy are discussed in the light of their advantages and disadvantages in assessing cervical remodeling. The authors propose that a combination of several imaging approaches, combined with clinical epidemiologic characteristics, holds the potential to accurately predict preterm birth [6]. Along this line, Petersen et al. discuss a timely concept which seeks understanding of the chronologically paced adaptations that synchronize the so-called pregnancy immune clock, taking advantage of multiomic ap
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