Etiologically Based Functional Taxonomy of the Preterm Birth Syndrome

Jose Villar; Paolo Ivo Cavoretto; Fernando C Barros; Roberto Romero; Aris T Papageorghiou; Stephen H Kennedy

doi:10.1016/j.clp.2024.02.014

Etiologically Based Functional Taxonomy of the Preterm Birth Syndrome

Clin Perinatol. 2024 Jun;51(2):475-495. doi: 10.1016/j.clp.2024.02.014. Epub 2024 Apr 4.

Authors

Jose Villar¹, Paolo Ivo Cavoretto², Fernando C Barros³, Roberto Romero⁴, Aris T Papageorghiou⁵, Stephen H Kennedy⁵

Affiliations

¹ Nuffield Department of Women's & Reproductive Health, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford OX3 9DU, UK. Electronic address: [email protected].
² Department of Obstetrics and Gynaecology, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan 20132, Italy.
³ Post-Graduate Program in Health in the Life Cycle, Catholic University of Pelotas, Rua Félix da Cunha, Pelotas, Rio Grande do Sul 96010-000, Brazil.
⁴ Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA; Department of Obstetrics and Gynecology, University of Michigan, L4001 Women's Hospital, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0276, USA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
⁵ Nuffield Department of Women's & Reproductive Health, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford OX3 9DU, UK.

PMID: 38705653
DOI: 10.1016/j.clp.2024.02.014

Abstract

Preterm birth (PTB) is a complex syndrome traditionally defined by a single parameter, namely, gestational age at birth (ie, ˂37 weeks). This approach has limitations for clinical usefulness and may explain the lack of progress in identifying cause-specific effective interventions. The authors offer a framework for a functional taxonomy of PTB based on (1) conceptual principles established a priori; (2) known etiologic factors; (3) specific, prospectively identified obstetric and neonatal clinical phenotypes; and (4) postnatal follow-up of growth and development up to 2 years of age. This taxonomy includes maternal, placental, and fetal conditions routinely recorded in data collection systems.

Keywords: Etiology; PPROM; Phenotype; Preterm birth; Preterm labor; Preterm prelabor rupture of membranes; Taxonomy.

Publication types

Review

MeSH terms

Female
Fetal Membranes, Premature Rupture
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Pregnancy
Premature Birth*
Risk Factors
Syndrome