PRETERM BIRTH

Abstract

Preterm birth, defined as delivery before 37 weeks' gestation, occurs in around 10% of pregnancies worldwide and is a major cause of neonatal morbidity and mortality. Prematurity has complex, multifactorial causes, including direct triggers as well as indirect factors. Immunological dysregulation plays a central role in prematurity, notably through premature activation of TLR-mediated NF-κB/MAPK pathways, cytokine production and immune cell infiltration, which result in uterine contractility. Non-invasive, biochemical and genetic biomarkers such as foetal fibronectin, cytokines (e.g. IL-6 and CXCL8), long non-coding RNAs (lncRNAs), microRNAs (miRNAs) and matrix metalloproteinases offer promising paths for early prediction of prematurity, enabling therapeutic strategies targeting inflammation, including TLR4 antagonists, broad-spectrum chemokine inhibitors, cytokine suppressive agents and microRNA-based therapies, to prevent preterm delivery.