The role of inflammation and infection in preterm birth.
Inflammation has been implicated in the mechanisms responsible for preterm and term parturition, as well as fetal injury. Out of all of the suspected causes of preterm labor and delivery, infection and/or inflammation is the only pathological process for which both a firm causal link with preterm birth has been established and a molecular pathophysiology defined. Inflammation has also been implicated in the mechanism of spontaneous parturition at term. Most cases of histopathological inflammation and histological chorioamnionitis, both in preterm and term labor, are sub-clinical in nature. The isolation of bacteria in the amniotic fluid, known as microbial invasion of the amniotic cavity, is a pathological finding; the frequency of which is dependent upon the clinical presentation and gestational age. This article reviews the role of inflammation in preterm and term parturition.
Romero
Roberto
R
Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA. warfiela@mail.nih.gov
Espinoza
Jimmy
J
Gonçalves
Luís F
LF
Kusanovic
Juan Pedro
JP
Friel
Lara
L
Hassan
Sonia
S
D000650:Amnion / Q000382:microbiology; D000653:Amniotic Fluid / Q000382:microbiology / Q000821:virology; D002821:Chorioamnionitis / Q000382:microbiology; D016207:Cytokines / Q000502:physiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005315:Fetal Diseases / Q000209:etiology; D005322:Premature Rupture of Fetal Membranes / Q000382:microbiology; D006801:Humans; D007239:Infections / Q000150:complications* / Q000382:microbiology; D007249:Inflammation / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011971:Receptors, Immunologic
D016207:Cytokines; D004279:DNA, Viral; D011971:Receptors, Immunologic