Genetic Polymorphism and Preterm Birth

Excerpt

Preterm birth is the most common cause of neonatal mortality and second most common cause of child mortality [1]. Preterm neonates are also at greater risk of neurodevelopmental disability including cerebral palsy, mental retardation, learning disabilities and behavioral disorders. Preterm birth is not a disease or diagnosis but end-result of many possible pathological processes which can lead to either spontaneous or indicated delivery. Rapid advances have been made in intensive care of prematurely born neonates. Antenatal steroids, non-invasive and invasive respiratory support, thermal management and nutritional support have led to remarkable improvement in survival of preterm neonates (tertiary prevention). However, no major gains have been achieved in prevention of preterm birth. Incidence of preterm birth is either static or increasing in different geographic areas [1, 2]. Prevention of preterm birth after onset of labor pains or preterm premature rupture of membranes (secondary prevention) has a limited role. Tocolytic agents prolong gestation for a short period only, sometime sufficient to achieve beneficial effect of antenatal steroids. Primary prevention of preterm birth (before onset of preterm labor or preterm premature rupture of membranes -pPROM) is hampered by poor understanding of various mechanisms which change the uterus from quiescence to active state. …