Chapter 12 - Hormones and Pre-term Birth

Summary

Pre-Term Birth (PTB) affects 5–18 percent of livebirths worldwide and despite advances in neonatal care, is the leading global cause of death of children under 5 years of age. PTB remains a major health inequality, and rates are increasing. PTB is a multifactorial syndrome; the biological mechanisms involved are incompletely understood, although several risk factors exist which form the focus for preventive strategies. Maternal steroid and thyroid hormones, their biosynthesis and bioavailability is fundamental for the appropriate development of fetuses, and any perturbations to these processes can have adverse developmental outcome such as PTB. Prediction of PTB proves challenging although enables targeted therapies to be offered with the intention of preventing or delaying birth, without unnecessary overtreatment. Several interventions exist which reduce the severe morbidity and mortality from PTB, including antenatal corticosteroids and magnesium sulphate therapy. Animal models of PTB help developing future therapeutic candidates for prevention of PTB in women.