Deindl Philipp, Diemert Anke
Department of Neonatology and Pediatric Intensive Care Medicine, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany.
Semin Immunopathol. 2020 Aug;42(4):377-383. doi: 10.1007/s00281-020-00805-0. Epub 2020 Aug 25.
Preterm birth is a global health problem that affects 11% of all live births: it remains a significant cause of death and an important cause of long-term loss of human potential among survivors all around the world. In the last decade, many developed countries have seen an increase in the rate of infants born preterm. Various theoretical and practical concepts have been discussed that aim to optimize the perinatal care of preterm infants and their mothers. These include the definition of hospitals with different levels of care, the regionalization of care, the creation of large care units with high case numbers, and a high level of expertise. This review article focuses on the connection between health care structures and different aspects of preterm birth. Furthermore, this review article highlights the fact that preterm birth is a heterogeneous syndrome with many underlying pathologies and that the causality for a large number of cases remains unexplained. There is still a significant knowledge gap concerning the actual drivers of spontaneous preterm birth, and future research particularly in parturition immunology as well as genetics of prematurity will be essential to identify new targets for therapy.
早产是一个全球性的健康问题，影响着11%的活产儿：它仍然是导致死亡的一个重要原因，也是世界各地幸存者长期丧失人类潜能的一个重要原因。在过去十年中，许多发达国家的早产婴儿出生率有所上升。人们讨论了各种理论和实践概念，旨在优化对早产婴儿及其母亲的围产期护理。这些概念包括不同护理水平医院的定义、护理的区域化、创建病例数多的大型护理单元以及高水平的专业知识。这篇综述文章重点关注医疗保健结构与早产不同方面之间的联系。此外，这篇综述文章强调了这样一个事实，即早产是一种具有多种潜在病理的异质性综合征，而且大量病例的因果关系仍无法解释。关于自发性早产的实际驱动因素仍存在重大知识空白，未来特别是在分娩免疫学以及早产遗传学方面的研究对于确定新的治疗靶点至关重要。
