A Comprehensive Integrative Review of the Factors Associated with Spontaneous Preterm Birth, Its Prevention and Prediction, Including Metabolomic Markers

Abstract

Preterm birth is a major maternal complication that has a great impact on perinatal and neonatal health, with consequences suffered during childhood and adulthood. Little is known about its etiology and development, resulting in poor screening, prediction and preventive methods. The present integrative review discusses the current knowledge regarding some risk factors for preterm birth, the differences between screening and prediction methods, the limitations of some current preventive interventions, the importance of applying standardized concepts for exposures and outcomes, and why it is important to develop more accurate and reproducible methods to predict preterm birth. In addition, the authors introduce the concept of metabolomics and the technology involved in this technique, and discuss about how it has become a promising approach to identify biomarkers for spontaneous preterm birth.

Resumo

Parto prematuro é uma complicação obstétrica de grande impacto para saúde perinatal e neonatal, tendo consequências também para a infância e a vida adulta. Pouco se sabe sobre sua etiologia e fatores determinantes, o que limita os métodos de rastreamento, predição e prevenção. Esta revisão integrativa traz a discussão sobre o conhecimento atual sobre fatores de risco para parto prematuro espontâneo, as diferenças entre métodos de rastreamento e predição, as limitações das atuais intervenções preventivas, a importância de se aplicar conceitos padronizados para exposição e desfecho na investigação de parto prematuro espontâneo, e porque é importante desenvolver métodos precisos e reprodutíveis para predizer o parto prematuro. Por fim, introduzimos o conceito de metabolômica e da tecnologia envolvida nessa técnica, e discutimos como ela tem se mostrado uma abordagem prosmissora para identificar biomarcadores associados ao parto prematuro espontâneo.

Keywords

preterm labor - premature rupture of fetal membranes - risk factors - screening programs - perinatology - metabolomics

Palavras-chave

trabalho de parto prematuro - ruptura prematura de membranas fetais - fatores de risco - programas de rastreamento - perinatologia - metabolômica

Contributors

Souza RT and Cecatti JG conceived and planned the concept of the current manuscript. Souza RT collated material for the first draft of the manuscript. Both authors read, reviewed and approved the final version of the manuscript.

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