Preterm labour. Biochemical and endocrinological preparation for parturition.

Preterm delivery is a common obstetric problem occurring in about 1 in 10 of all births. Preterm babies have a high risk of morbidity and mortality. Such births account for 75% of all major neonatal problems. At the other end of the spectrum, prolonged pregnancy is also a subject of concern because it too is associated with increased fetal morbidity and mortality. Despite extensive research, the mechanisms that control the length of human pregnancy and signal the onset of labour have not been fully determined. This chapter will discuss basic principles in the biology of parturition and the regulation of contraction-associated proteins including the oxytocin receptor. The major pathways regulating contractions and the transcriptional regulation of the main genes that are known to be involved in the onset of labour and parturition will be examined. Some new potentially therapeutic strategies for the biochemical management of preterm labour will be discussed.