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Preterm Birth: Causes, Consequences, and Prevention
Summary of Pathophysiological Mechanisms
An understanding of the relevant pathophysiological mechanisms of preterm birth is necessary to develop rationale and efficacious intervention strategies in preventing and treating preterm birth and its sequelae in neonates. Animal models provide a unique opportunity to study longitudinally the causes and consequences of preterm birth in a controlled experimental environment that cannot be created in women. However, many animal models have important limitations based on the length of gestation, the endocrine events of parturition, the presence of multiple fetuses, and fetal developmental milestones. Experimental animal models must be developed that address specific questions on the basis of their similarities or relevance to the research questions important in human preterm birth. These include the use of
nonhuman primates to describe the temporal or longitudinal relationships among the mediators of preterm labor;
genetically altered mice to ascertain the roles that putative mediators of preterm birth has in leading to prematurity; and
sheep or nonhuman primates to ascertain the relationships among the various pathways to preterm birth and their sequelae in neonates, such as cerebral white matter injury and bronchopulmonary dysplasia.