Molecular Insight into the Pathogenesis of Spontaneous Preterm Birth

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cellular Pathology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 1795

Special Issue Editor


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Guest Editor
School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
Interests: preterm birth; placental epigenetics and molecular function; placental transcriptome; placental microbiome; climate change impact of placental function and adverse pregnancy outcomes

Special Issue Information

Dear Colleagues,

Preterm birth (PTB) is the leading cause of mortality among neonates and children under five years of age. Each year, over 15 million babies are born preterm worldwide, with more than 1 million succumbing to complications, accounting for 35% of all newborn deaths. Furthermore, moderate to late preterm births, which occur more frequently, are associated with an elevated risk of significant cognitive and neurodevelopmental anomalies in early childhood. The majority of preterm births (~70%) occur spontaneously, with no identifiable cause. Although the underlying mechanisms of spontaneous PTB remain poorly understood, several multifactorial risk factors have been implicated, including infections, trophoblast and decidual senescence, impaired placental autophagy, disruptions in maternal–fetal immune tolerance, maternal stress, and uterine vascular disorders. These factors often interact with various epigenetic, genetic, and environmental predispositions. Vaginal dysbiosis, characterized by the replacement of Lactobacillus species with other bacteria such as Gardnerella vaginalis, has also been linked to spontaneous PTB, although the precise mechanisms driving this association remain unclear.

This Special Issue of Cells aims to showcase recent advances in the understanding of the molecular mechanisms underlying preterm birth through a collection of original research articles, reviews, and communications. Topics will include molecular insights into placental dysfunction, maternal stress, fetal factors, vaginal dysbiosis, environmental influences, and other risk factors contributing to the pathogenesis of preterm birth.

Dr. Khondoker M. Akram
Guest Editor

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Keywords

  • pathogenesis of preterm birth
  • placental dysfunctions in preterm birth
  • environmental impacts on placental function in preterm birth
  • vaginal dysbiosis in preterm birth

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Published Papers (2 papers)

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Research

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22 pages, 4264 KiB  
Article
Seasonal Influences on Human Placental Transcriptomes Associated with Spontaneous Preterm Birth
by Khondoker M. Akram, Eleanor Dodd and Dilly O. C. Anumba
Cells 2025, 14(4), 303; https://doi.org/10.3390/cells14040303 - 18 Feb 2025
Viewed by 1132
Abstract
Demographic studies have revealed a strong association between exposure to high ambient temperatures during pregnancy and increased risks of preterm birth (PTB). The mechanism underlying this association is unclear, but it is plausible that altered placental function may contribute to it. In this [...] Read more.
Demographic studies have revealed a strong association between exposure to high ambient temperatures during pregnancy and increased risks of preterm birth (PTB). The mechanism underlying this association is unclear, but it is plausible that altered placental function may contribute to it. In this study, we conducted differential gene expression analysis, gene set enrichment analysis (GSEA), and gene ontology (GO) analysis on bulk RNA-seq data from human placentas delivered at term and preterm during the warmer months compared to placentas delivered at term and preterm during the colder months in the UK. We detected 48 differentially expressed genes in preterm placentas delivered during the warmer months compared to preterm placentas delivered during the colder months, the majority of which were inflammatory cytokines and chemokines, including SERPINA1, IL1B, CCL3, CCL3L3, CCL4, CCL4L2, CCL20, and CXCL8. The GSEA positively enriched 17 signalling pathways, including the NF-κB, IL17, Toll-like receptor, and chemokine signalling pathways in preterm placentas delivered during warmer months. These results were not observed in the placentas delivered at term during the same times of the year. The GO analysis revealed several enhanced biological processes, including neutrophil, granulocyte, monocyte, and lymphocyte chemotaxis, as well as inflammatory and humoral immune responses in preterm placentas, but not in placentas delivered at term in the summer. We conclude that maternal exposure to warm environmental temperatures during pregnancy likely alters the placental transcriptomes towards inflammation and immune regulation, potentially leading to PTB. Full article
(This article belongs to the Special Issue Molecular Insight into the Pathogenesis of Spontaneous Preterm Birth)
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Review

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16 pages, 1248 KiB  
Review
Placental Inflammation in Preterm Premature Rupture of Membranes and Risk of Neurodevelopmental Disorders
by Elizabeth Marie Cervantes and Sylvie Girard
Cells 2025, 14(13), 965; https://doi.org/10.3390/cells14130965 - 24 Jun 2025
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Abstract
Preterm premature rupture of membranes (pPROM) is a leading cause of preterm birth (PTB) and is increasingly recognized for its association with neurodevelopmental disorders (NDDs). The disruption of fetal membrane integrity introduces potential infection and inflammation into the intrauterine environment, triggering immune responses [...] Read more.
Preterm premature rupture of membranes (pPROM) is a leading cause of preterm birth (PTB) and is increasingly recognized for its association with neurodevelopmental disorders (NDDs). The disruption of fetal membrane integrity introduces potential infection and inflammation into the intrauterine environment, triggering immune responses that may affect fetal development. Placental inflammation plays a pivotal role in mediating these effects, exposing the fetus to cytokines, oxidative stress, and potential microbial insults that contribute to adverse neurodevelopmental outcomes. This review examines the current evidence of the mechanistic pathways linking pPROM-induced placental inflammation to NDDs, emphasizing the roles of pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs) in the inflammatory responses. We discuss how these immune activations lead to immune cell recruitment and excessive (or uncontrolled) production of inflammatory mediators, leading to an overall inflammatory imbalance that has been linked to disrupted fetal brain development in animal models. Animal models provide critical insights into how both sterile and pathogenic placental inflammation alter fetal neurodevelopment, while human studies, though limited, highlight promising biomarkers and potential therapeutic targets. This review identifies critical knowledge gaps and outlines future directions to mitigate the impact of placental inflammation on long-term infant health. Full article
(This article belongs to the Special Issue Molecular Insight into the Pathogenesis of Spontaneous Preterm Birth)
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