早产的发生机制及预测因子新进展
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摘要
早产是导致围生儿死亡及新生儿疾病的重要因素,是临床工作中频繁出现的挑战与难题.影响早产的因素众多,生理或心理因素、先天或后天因素都可能在妊娠过程中引致早产.早产的机制更复杂,可能与炎症机制、内分泌系统的调节、母体基因背景等有关.目前临床上预测早产的手段较为局限,综合早产的病因机制及预测因子,查找更多的早产预测因子,为早产的诊断与防治提供依据.
Premature birth is a highly risk factor for perinatal death and neonatal diseases. It is a challenge and problem in the clinic. There are many factors affecting preterm birth, such as physical and psychological factors, congenital and acquired diseases. The pathogenesis of preterm birth is complicate, and may be related to inflammation and infection, dysregulation of endocrine system, genetic background, and so on. The methods for predicting preterm birth are limited now. This review has been summarized the etiology and predictors of preterm birth in order to find out the predictors of preterm birth for diagnosis and prevention.
Premature birth is a highly risk factor for perinatal death and neonatal diseases. It is a challenge and problem in the clinic. There are many factors affecting preterm birth, such as physical and psychological factors, congenital and acquired diseases. The pathogenesis of preterm birth is complicate, and may be related to inflammation and infection, dysregulation of endocrine system, genetic background, and so on. The methods for predicting preterm birth are limited now. This review has been summarized the etiology and predictors of preterm birth in order to find out the predictors of preterm birth for diagnosis and prevention.
引文
[1] 陈友鹏,李健,HOCHER Berthold.肾素-血管紧张素系统构建在高血压胚胎起源学说中的重要性[J].中国病理生理杂志,2010,26(11):2270-2273.CHEN Y P,LI J,HOCHER B.Role of fetal programming of renin-angiotensin system in adult hypertension[J].Chinese Journal of Pathophysiology,2010,26(11):2270-2273.
[2] BLENCOWE H,COUSENS S,CHOU D,et al.Born too soon:the global epidemiology of 15 million preterm births[J].Reproductive Health,2013,10(Suppl 1):S2.
[3] SIMHAN H N B V,IAMS J D.Preterm labor and birth[M]//CREASY R K RESNICK R,IAMS J D,et al.Creasy & Resnick’s maternal-fetal medicine:principles and practice.Philidelphia,PA:Elsevier/Saunders;2014:624-653.
[4] ROMERO R,DEY S K,FISHER S J.Preterm labor:one syndrome,many causes[J].Science,2014,345(6198):760-765.
[5] GOMEZ-LOPEZ N,STLOUIS D,LEHR M A,et al.Immune cells in term and preterm labor[J].Cellular & Molecular Immunology,2014,11(6):571-581.
[6] HEE L.Likelihood ratios for the prediction of preterm delivery with biomarkers[J].Acta Obstet Gynecol Scand,2011,90(11):1189-1199.
[7] GILLESPIE S L,CHRISTIAN L M,NEAL J L.A proposed bio-panel to predict risk for spontaneous preterm birth among African American women[J].Medical Hypotheses,2015,85(5):558-564.
[8] MENON R,FORTUNATO S J.Infection and the role of inflammation in preterm premature rupture of the membranes[J].Best Pract Res Clin Obstet Gynaecol,2007,21(3):467-478.
[9] CORDEIRO C N,SAVVA Y,VAIDYA D,et al.Mathematical modeling of the biomarker milieu to characterize preterm birth and predict adverse neonatal outcomes[J].Am J Reprod Immunol,2016,75(5):594-601.
[10] STAMPALIJA T,CHAIWORAPONGSA T,ROMERO R,et al.Soluble ST2,a modulator of the inflammatory response in preterm and term labor[J].J Matern Fetal Neonatal Med,2014,27(2):111-121.
[11] RAMASAMY R,YAN S F,HEROLD K,et al.Receptor for advanced glycation end products:fundamental roles in the inflammatory response:winding the way to the pathogenesis of endothelial dysfunction and atherosclerosis[J].Annals of the New York Academy of Sciences,2008,1126:7-13.
[12] WALSH M C,CHOI Y.Biology of the RANKL-RANK-OPG system in immunity,bone,and beyond[J].Front Immunol,2014,20(5):511.
[13] RZEPKA R,DO?GOWSKA B,SA?ATA D,et al.Soluble receptors for advanced glycation end products and receptor activator of NF-κB ligand serum levels as markers of premature labor[J].BMC Pregnancy Childbirth,2015,10(15):134.
[14] PAQUETTE A G,SHYNLOVA O,KIBSCHULL M,et al.Comparative analysis of gene expression in maternal peripheral blood and monocytes during spontaneous preterm labor[J].Am J Obstet Gynecol,2018,218(3):345.e1-345.e30.
[15] DRUCKMANN R,DRUCKMANN M A.Progesterone and the immunology of pregnancy[J].J Steroid Biochem Mol Biol,2005,97(5):389-396.
[16] HUDI I,FATU?I Z.Progesterone-induced blocking factor (PIBF) and Th(1)/Th(2) cytokine in women with threatened spontaneous abortion[J].J Perinat Med,2009,37(4):338-342.
[17] HUDI I,SZEKERES-BARTHO J,STRAY-PEDERSEN B,et al.Lower urinary and serum progesterone-induced blocking factor in women with preterm birth[J].J Reprod Immunol,2016,117:66-69.
[18] OHNISHL J,OHNISHI E,SHIBUYA H,et al.Functions for proteinases in the ovulatory process[J].Biochim Biophys Acta,2005,1751(1):95-109.
[19] DANE B N,DANE C,BATMAZ G,et al.First trimester maternal serum pregnancy-associated plasma protein-A is a predictive factor for early preterm delivery in normotensive pregnancies[J].Gynecol Endocrinol,2013,29(6):592-595.
[20] 陈友鹏,李健,HOCHER Berthold.血管紧张素转化酶2-血管紧张素(1-7)-Mas受体轴在胚胎生长发育中的重要性[J].中华围产医学杂志,2012,15(7):445-447.CHEN Y P,LI J,HOCHER B.The importance of angiotensin converting enzyme 2-angiotensin (1-7)-Mas receptor axis in fetal growth and development[J].Chin J Perinal Med,2012,15(7):445-447.
[21] 卢永平,陈友鹏,刘志威,等.母婴血循环中Ang(1-7)水平对早产的影响[J].暨南大学学报(自然科学与医学版),2013,34(6):626-631.LU Y P,CHEN Y P,LIU Z W,et al.Impact of both maternal and neonatal plasma angiotensin(1-7) levels on preterm delivery[J].Journal of Jinan University (Natural Science and Medicine Edition),2013,34(6):626-631.
[22] GOMEZ-LOPEZ N,ROMERO R,PLAZYO O,et al.Preterm labor in the absence of acute histologic chorioamnionitis is characterized by cellular senescence of the chorioamniotic membranes[J].Am J Obstet Gynecol,2017,217(5):592.e1-e17.
[23] ELOVITZ M A,BROWN A G,ANTON L,et al.Distinct cervical microRNA profiles are present in women destined to have a preterm birth[J].Am J Obstet Gynecol,2014,210(3):221.e1-e11.
[24] GOYAL M,KRIPLANI A,KACHHAWA G,et al.Prediction of preterm labor by a rapid bedside test detecting phosphorylated insulin-like growth factor-binding protein 1 in cervical secretions[J].Int J Gynaecol Obstet,2016,134(2):165-168.
[25] TRIPATHI R,TYAGI S.Comparison of rapid bedside tests for phosphorylated insulin-like growth factor-binding protein 1 and fetal fibronectin to predict preterm birth[J].Int J Gynaecol Obstet,2016,135(1):47-50.
[26] LIU R,JIN J P.Calponin isoforms CNN1,CNN2 and CNN3:regulators for actin cytoskeleton functions in smooth muscle and non-muscle cells[J].Gene,2016,585(1):143-153.
[27] CETIN O,KARAMAN E,BOZA B,et al.Maternal serum calponin 1 level as a biomarker for the short-term prediction of preterm birth in women with threatened preterm labor[J].J Matern Fetal Neonatal Med,2018,31(2):216-222.
[2] BLENCOWE H,COUSENS S,CHOU D,et al.Born too soon:the global epidemiology of 15 million preterm births[J].Reproductive Health,2013,10(Suppl 1):S2.
[3] SIMHAN H N B V,IAMS J D.Preterm labor and birth[M]//CREASY R K RESNICK R,IAMS J D,et al.Creasy & Resnick’s maternal-fetal medicine:principles and practice.Philidelphia,PA:Elsevier/Saunders;2014:624-653.
[4] ROMERO R,DEY S K,FISHER S J.Preterm labor:one syndrome,many causes[J].Science,2014,345(6198):760-765.
[5] GOMEZ-LOPEZ N,STLOUIS D,LEHR M A,et al.Immune cells in term and preterm labor[J].Cellular & Molecular Immunology,2014,11(6):571-581.
[6] HEE L.Likelihood ratios for the prediction of preterm delivery with biomarkers[J].Acta Obstet Gynecol Scand,2011,90(11):1189-1199.
[7] GILLESPIE S L,CHRISTIAN L M,NEAL J L.A proposed bio-panel to predict risk for spontaneous preterm birth among African American women[J].Medical Hypotheses,2015,85(5):558-564.
[8] MENON R,FORTUNATO S J.Infection and the role of inflammation in preterm premature rupture of the membranes[J].Best Pract Res Clin Obstet Gynaecol,2007,21(3):467-478.
[9] CORDEIRO C N,SAVVA Y,VAIDYA D,et al.Mathematical modeling of the biomarker milieu to characterize preterm birth and predict adverse neonatal outcomes[J].Am J Reprod Immunol,2016,75(5):594-601.
[10] STAMPALIJA T,CHAIWORAPONGSA T,ROMERO R,et al.Soluble ST2,a modulator of the inflammatory response in preterm and term labor[J].J Matern Fetal Neonatal Med,2014,27(2):111-121.
[11] RAMASAMY R,YAN S F,HEROLD K,et al.Receptor for advanced glycation end products:fundamental roles in the inflammatory response:winding the way to the pathogenesis of endothelial dysfunction and atherosclerosis[J].Annals of the New York Academy of Sciences,2008,1126:7-13.
[12] WALSH M C,CHOI Y.Biology of the RANKL-RANK-OPG system in immunity,bone,and beyond[J].Front Immunol,2014,20(5):511.
[13] RZEPKA R,DO?GOWSKA B,SA?ATA D,et al.Soluble receptors for advanced glycation end products and receptor activator of NF-κB ligand serum levels as markers of premature labor[J].BMC Pregnancy Childbirth,2015,10(15):134.
[14] PAQUETTE A G,SHYNLOVA O,KIBSCHULL M,et al.Comparative analysis of gene expression in maternal peripheral blood and monocytes during spontaneous preterm labor[J].Am J Obstet Gynecol,2018,218(3):345.e1-345.e30.
[15] DRUCKMANN R,DRUCKMANN M A.Progesterone and the immunology of pregnancy[J].J Steroid Biochem Mol Biol,2005,97(5):389-396.
[16] HUDI I,FATU?I Z.Progesterone-induced blocking factor (PIBF) and Th(1)/Th(2) cytokine in women with threatened spontaneous abortion[J].J Perinat Med,2009,37(4):338-342.
[17] HUDI I,SZEKERES-BARTHO J,STRAY-PEDERSEN B,et al.Lower urinary and serum progesterone-induced blocking factor in women with preterm birth[J].J Reprod Immunol,2016,117:66-69.
[18] OHNISHL J,OHNISHI E,SHIBUYA H,et al.Functions for proteinases in the ovulatory process[J].Biochim Biophys Acta,2005,1751(1):95-109.
[19] DANE B N,DANE C,BATMAZ G,et al.First trimester maternal serum pregnancy-associated plasma protein-A is a predictive factor for early preterm delivery in normotensive pregnancies[J].Gynecol Endocrinol,2013,29(6):592-595.
[20] 陈友鹏,李健,HOCHER Berthold.血管紧张素转化酶2-血管紧张素(1-7)-Mas受体轴在胚胎生长发育中的重要性[J].中华围产医学杂志,2012,15(7):445-447.CHEN Y P,LI J,HOCHER B.The importance of angiotensin converting enzyme 2-angiotensin (1-7)-Mas receptor axis in fetal growth and development[J].Chin J Perinal Med,2012,15(7):445-447.
[21] 卢永平,陈友鹏,刘志威,等.母婴血循环中Ang(1-7)水平对早产的影响[J].暨南大学学报(自然科学与医学版),2013,34(6):626-631.LU Y P,CHEN Y P,LIU Z W,et al.Impact of both maternal and neonatal plasma angiotensin(1-7) levels on preterm delivery[J].Journal of Jinan University (Natural Science and Medicine Edition),2013,34(6):626-631.
[22] GOMEZ-LOPEZ N,ROMERO R,PLAZYO O,et al.Preterm labor in the absence of acute histologic chorioamnionitis is characterized by cellular senescence of the chorioamniotic membranes[J].Am J Obstet Gynecol,2017,217(5):592.e1-e17.
[23] ELOVITZ M A,BROWN A G,ANTON L,et al.Distinct cervical microRNA profiles are present in women destined to have a preterm birth[J].Am J Obstet Gynecol,2014,210(3):221.e1-e11.
[24] GOYAL M,KRIPLANI A,KACHHAWA G,et al.Prediction of preterm labor by a rapid bedside test detecting phosphorylated insulin-like growth factor-binding protein 1 in cervical secretions[J].Int J Gynaecol Obstet,2016,134(2):165-168.
[25] TRIPATHI R,TYAGI S.Comparison of rapid bedside tests for phosphorylated insulin-like growth factor-binding protein 1 and fetal fibronectin to predict preterm birth[J].Int J Gynaecol Obstet,2016,135(1):47-50.
[26] LIU R,JIN J P.Calponin isoforms CNN1,CNN2 and CNN3:regulators for actin cytoskeleton functions in smooth muscle and non-muscle cells[J].Gene,2016,585(1):143-153.
[27] CETIN O,KARAMAN E,BOZA B,et al.Maternal serum calponin 1 level as a biomarker for the short-term prediction of preterm birth in women with threatened preterm labor[J].J Matern Fetal Neonatal Med,2018,31(2):216-222.