Khandre Vivekanand, Potdar Jyotsana, Keerti Akshunna
Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Dec 27;14(12):e33006. doi: 10.7759/cureus.33006. eCollection 2022 Dec.
Birth order has a significant impact on perinatal and long-term outcomes. Preterm birth rates, ranging from 5% to 18%, are regrettably still high in industrialized and developing countries, making them the main contributor to infant mortality and morbidity. Infection, cervical pathology, uterine overdistension, progesterone deficiency, stress on the mother and fetus, allograft reaction, allergic phenomena, and likely more unknown factors are just a few of the causes of preterm birth syndrome. These several causes may improperly stimulate the usual pathway between the decidua and the fetal membranes, resulting in cervical ripening, membrane rupture, and uterine contractility. Some of the mechanisms underpinning these actions include receptors, chemokines, and inflammatory cytokines. For early identification, treatment, and avoidance of negative consequences, it is essential to understand the cellular and metabolic mechanisms that cause preterm labor. Clinicians and researchers are crucial to improving our knowledge of the biochemistry of preterm delivery, identifying risk factors, and creating treatments for this challenging condition. Intrauterine growth restriction and pre-eclampsia or eclampsia are frequent causes of suspected preterm births. "Spontaneous preterm births" occur after preterm labor that develops without warning with an early membrane rupture. It is thought that the condition that may cause these births may have several causes, such as uterine overdistension, vascular disease, infection, or inflammation. Unplanned preterm births have several reasons, including the black race, periodontal disease, low mother body mass index (BMI), and previous preterm births. A short cervical length and a high cervical-vaginal fetal fibronectin concentration are the two best signs of premature birth.
出生顺序对围产期及长期结局有重大影响。在工业化国家和发展中国家，早产率仍令人遗憾地高达5%至18%，这使其成为婴儿死亡率和发病率的主要原因。感染、宫颈病变、子宫过度扩张、孕酮缺乏、母体和胎儿应激、同种异体移植反应、过敏现象以及可能更多未知因素，只是早产综合征的部分病因。这些多种病因可能不当刺激蜕膜与胎膜之间的正常通路，导致宫颈成熟、胎膜破裂和子宫收缩。支撑这些作用的一些机制包括受体、趋化因子和炎性细胞因子。为了早期识别、治疗并避免不良后果，了解导致早产的细胞和代谢机制至关重要。临床医生和研究人员对于增进我们对早产生物化学的认识、识别危险因素以及为这一具有挑战性的病症制定治疗方法至关重要。宫内生长受限和先兆子痫或子痫是疑似早产的常见原因。“自发性早产”发生在无预警且胎膜早破的早产之后。据认为，可能导致这些早产的情况可能有多种原因，如子宫过度扩张、血管疾病、感染或炎症。计划外早产有多种原因，包括黑人种族、牙周病、母亲低体重指数（BMI）以及既往早产史。宫颈长度缩短和宫颈 - 阴道胎儿纤连蛋白浓度升高是早产的两个最佳迹象。
