Role of cytokines in preterm labor and birth

J. S. Park, C. W. Park, C. J. Lockwood, E. R. Norwitz

Research output: Contribution to journalReview article

72 Scopus citations

Abstract

Preterm birth (defined as delivery prior to 37 weeks' gestation) complicates 5-10% of all births. It is a major cause of perinatal mortality and morbidity. Approximately 20% of all preterm births are iatrogenic resulting from obstetric intervention for maternal and/or fetal indications. Of the remainder, 2/3 are spontaneous preterm labor with or without preterm premature rupture of the membranes (pPROM). Preterm labor is a syndrome rather than a diagnosis since the etiologies are varied. Risk factors include, among others, pPROM, cervical insufficiency, pathologic uterine distention (polyhydramnios, multiple gestation), uterine anomalies, intrauterine infection/inflammation, and social factors (stress, smoking, heavy work). The final common pathway appears to be activation of the inflammatory cascade. Bacterial colonization and/or inflammation of the choriodecidual interface induces production of pro-inflammatory cytokines that, in turn, lead to neutrophil activation and the synthesis and release of uterotonins such as prostaglandins (which cause uterine contractions) and metalloproteinases (that weaken fetal membranes and remodel cervical collagen). This monograph reviews the role of cytokines in the pathophysiology of preterm labor and delivery.

Original languageEnglish
Pages (from-to)349-366
Number of pages18
JournalMinerva Ginecologica
Volume57
Issue number4
StatePublished - 1 Aug 2005

Keywords

  • Cytokines
  • Intrauterine infection
  • Intrauterine inflammation
  • Preterm labor
  • Prostaglandins

Cite this

Park, J. S., Park, C. W., Lockwood, C. J., & Norwitz, E. R. (2005). Role of cytokines in preterm labor and birth. Minerva Ginecologica, 57(4), 349-366.