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Open AccessReview

Allostatic Load and Preterm Birth

Departments of Obstetrics and Gynecology, Pediatrics and Physiology, University of Alberta, Edmonton, AB T6G 2S2, Canada
Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB T1K 3M4, Canada
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Philip Newton Baker
Int. J. Mol. Sci. 2015, 16(12), 29856-29874;
Received: 3 September 2015 / Revised: 3 December 2015 / Accepted: 4 December 2015 / Published: 15 December 2015
(This article belongs to the Special Issue Prediction, Diagnostics and Prevention of Pregnancy Complications)
PDF [2220 KB, uploaded 15 December 2015]


Preterm birth is a universal health problem that is one of the largest unmet medical needs contributing to the global burden of disease. Adding to its complexity is that there are no means to predict who is at risk when pregnancy begins or when women will actually deliver. Until these problems are addressed, there will be no interventions to reduce the risk because those who should be treated will not be known. Considerable evidence now exists that chronic life, generational or accumulated stress is a risk factor for preterm delivery in animal models and in women. This wear and tear on the body and mind is called allostatic load. This review explores the evidence that chronic stress contributes to preterm birth and other adverse pregnancy outcomes in animal and human studies. It explores how allostatic load can be used to, firstly, model stress and preterm birth in animal models and, secondly, how it can be used to develop a predictive model to assess relative risk among women in early pregnancy. Once care providers know who is in the highest risk group, interventions can be developed and applied to mitigate their risk. View Full-Text
Keywords: allostatic load; allostasis; chronic stress; preterm birth; inflammation; two hits; multiple hit hypothesis; adverse pregnancy outcomes allostatic load; allostasis; chronic stress; preterm birth; inflammation; two hits; multiple hit hypothesis; adverse pregnancy outcomes

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Olson, D.M.; Severson, E.M.; Verstraeten, B.S.E.; Ng, J.W.Y.; McCreary, J.K.; Metz, G.A.S. Allostatic Load and Preterm Birth. Int. J. Mol. Sci. 2015, 16, 29856-29874.

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