A MODERN VIEW ON THE ETHIOPATOGENESIS OF PRETERN BIRTH. REVIEW.

Abstract

Introduction: Among all pregnancies worldwide, approximately 5 to 18% end prematurely, a major cause of infant
morbidity and mortality. About 70% are spontaneous preterm births and have multiple comorbid causes. Prevention and
treatment of preterm birth is an unresolved worldwide problem in modern obstetrics. It is for this reason that studying the
pathogenetic mechanisms of preterm birth, which threaten the health and well-being of future generations and represents a
major scientific challenge requiring both moral and material investment.
Aim: An analysis of the literature on the role of etiopathogenetic mechanisms of preterm birth.
Search strategy: Sources were searched in PubMed, Medline, Cochrane Library, Web of Science, Embase and Google
Scholar, e-Library. The depth of the search was 10 years, from 2011 to 2021. Inclusion criteria: full-text articles in Russian
and English, reports of cohort and randomized trials describing different etiopathogenetic mechanisms of preterm birth. This
review did not include publications describing single cases, abstracts of reports, personal communications and abstracts.
Results: The search retrieved 797 articles. After reviewing titles, abstracts, and full text, 80 sources were selected for
detailed review, describing all currently known etio-pathogenetic mechanisms of preterm birth. Among the most significant
are the following:
1. activation of the central nervous system (pituitary and hypothalamus) by both the fetus and the mother;
2. preterm birth associated with the development of pregnancy complications, such as: detachment of the normally
located placenta, severe pre-eclampsia, acute placental insufficiency, etc.;
3. triggering an inflammatory reaction and involvement of the uterine-placental complex, both with and without the
identification of an infective agent.
Conclusions: The analysis of the sources once again demonstrates the polyetiology of the problem. It is clear that preterm birth
continues to be an issue for a long time due to the lack of a complete understanding of the pathogenetic mechanisms.