Molecular Regulation of Parturition: The Role of the Decidual Clock.
The timing of birth is a critical determinant of perinatal outcome. Despite intensive research, the molecular mechanisms responsible for the onset of labor both at term and preterm remain unclear. It is likely that a "parturition cascade" exists that triggers labor at term, that preterm labor results from mechanisms that either prematurely stimulate or short-circuit this cascade, and that these mechanisms involve the activation of proinflammatory pathways within the uterus. It has long been postulated that the fetoplacental unit is in control of the timing of birth through a "placental clock." We suggest that it is not a placental clock that regulates the timing of birth, but rather a "decidual clock." Here, we review the evidence in support of the endometrium/decidua as the organ primarily responsible for the timing of birth and discuss the molecular mechanisms that prime this decidual clock.
Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, Massachusetts 02111 Mother Infant Research Institute (MIRI), Tufts University School of Medicine, Boston, Massachusetts 02110.
Errol R
ER
Norwitz
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont, Burlington, Vermont 05405.
Elizabeth A
EA
Bonney
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island 02905.
Victoria V
VV
Snegovskikh
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115.
Michelle A
MA
Williams
Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts 02114.
Mark
M
Phillippe
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-799, Korea.
Joong Shin
JS
Park
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06510.
Vikki M
VM
Abrahams
D000818:Animals; D001683:Biological Clocks / Q000502:physiology*; D003656:Decidua / Q000502:physiology*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005865:Gestational Age; D006801:Humans; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D047928:Premature Birth / Q000235:genetics; D011453:Prostaglandins / Q000502:physiology; D014599:Uterus / Q000502:physiology
D011453:Prostaglandins