早产：一种综合征，多种病因。
Preterm labor: one syndrome, many causes.
机构信息
Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, MD, Wayne State University/the Detroit Medical Center, Detroit, MI, USA. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Division of Reproductive Sciences, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
出版信息
Science. 2014 Aug 15;345(6198):760-5. doi: 10.1126/science.1251816. Epub 2014 Aug 14.
Preterm birth is associated with 5 to 18% of pregnancies and is a leading cause of infant morbidity and mortality. Spontaneous preterm labor, a syndrome caused by multiple pathologic processes, leads to 70% of preterm births. The prevention and the treatment of preterm labor have been long-standing challenges. We summarize the current understanding of the mechanisms of disease implicated in this condition and review advances relevant to intra-amniotic infection, decidual senescence, and breakdown of maternal-fetal tolerance. The success of progestogen treatment to prevent preterm birth in a subset of patients at risk is a cause for optimism. Solving the mystery of preterm labor, which compromises the health of future generations, is a formidable scientific challenge worthy of investment.
早产与 5%至 18%的妊娠有关，是婴儿发病率和死亡率的主要原因。自发性早产是一种由多种病理过程引起的综合征，导致 70%的早产。早产的预防和治疗一直是一个长期存在的挑战。我们总结了目前对与这种疾病相关的发病机制的理解，并回顾了与羊膜内感染、蜕膜衰老和母婴耐受破坏相关的进展。孕激素治疗在一部分高危患者中预防早产的成功是令人乐观的。解决危及后代健康的早产之谜是一项艰巨的科学挑战，值得投资。
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