title: Prematurity: present and future.
abstract: The study of preterm labor and prematurity has undergone a major transformation in its approach from an inevitable part of obstetrics with few answers to one in which science has led to knowledge and clinical intervention. Despite these advancements, understanding of preterm labor and prevention of prematurity is still limited. In the current review, we begin the discussion with fetal viability, first from a historical perspective and then from the understanding of this issue from a prospective of various professional organizations. We then present the scope of the problem of preterm birth from various countries including the discrepancy between the US and Europe. We continue with updates on extreme prematurity and outcomes with two longitudinal studies from the past 2 years. We further review available interventions for prematurity and discuss the use of antenatal corticosteroids. First, we examine their use in the context of professional recommendations and then examine the trajectory of their continued use in the late preterm period. We focus on a European-based trial with preliminary results and an ongoing American counterpart. The current knowledge of molecular mechanisms behind preterm labor is presented with a focus on the multiple etiologies of preterm labor, both known and presumed, with updates in the basic science realm. Furthermore, we present up-to-date studies on prediction of preterm birth and prematurity-related morbidity.
authors.affiliation: Integrated Research Center for Fetal Medicine Division of Maternal‑Fetal Medicine Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine - Integrated Research Center for Fetal Medicine Division of Maternal‑Fetal Medicine Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine.
authors.forename: M E
authors.initials: ME
authors.lastname: Tsimis
authors.forename: N
authors.initials: N
authors.lastname: Abu Al-Hamayel
authors.forename: H
authors.initials: H
authors.lastname: Germaine
authors.forename: I
authors.initials: I
authors.lastname: Burd
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000818:Animals; D005260:Female; D005328:Fetal Viability / Q000502:physiology*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*
chemical_list: D000305:Adrenal Cortex Hormones