{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:40:14Z","timestamp":1792662014807,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Preterm birth is the leading cause of death among children aged under 5\u2009years of age worldwide. Maternal genitourinary tract infections (GUTIs) are among the few modifiable risk factors for spontaneous preterm labor (sPTL), yet the gap between association and effective intervention remains unresolved. This narrative review consolidates recent evidence on GUTIs and sPTL, integrating pathogens, ascending and hematogenous pathways, and prevention. MEDLINE, Embase, the Cochrane Library, and Scopus were searched (January 2000\u2013January 2026); evidence was synthesized narratively and stratified by preterm\u2010birth subtype where possible. Pooled estimates showed increased odds of preterm birth with urinary tract infection (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.62\u20132.27), asymptomatic bacteriuria (ASB; OR 1.62, 95% CI 1.30\u20132.01), bacterial vaginosis (OR 1.79, 95% CI 1.32\u20132.43),\n                    <jats:italic>Ureaplasma<\/jats:italic>\n                    colonization (OR 2.76, 95% CI 1.63\u20134.68),\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    (relative risk 1.42, 95% CI 1.15\u20131.75), and\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    (OR 1.57, 95% CI 1.11\u20132.22). A 2026 Swedish register cohort (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009684\u2009595) demonstrates that the hazard for preterm birth after urinary tract infection (UTI) diagnosis is highest in the first 6\u2009days and declines with advancing gestation (adjusted hazard ratios 18.5, 13.5, and 6.7 at 22\u201327, 28\u201331, and 32\u201336\u2009weeks). Gene\u2013environment analyses further indicate that preterm birth subtypes differ in susceptibility to UTI versus vaginal infection. Antibiotic treatment of ASB reduces pyelonephritis (RR 0.24), but its effect on preterm birth in unselected populations is uncertain. Ascending infection drives decidual cytokine release and premature myometrial activation; amniotic\u2010fluid sludge on transvaginal ultrasound is an accessible marker of subclinical intra\u2010amniotic infection. Targeted screening, evidence\u2010based antibiotic selection, and antimicrobial stewardship remain the practical priorities.\n                  <\/jats:p>","DOI":"10.1002\/ijgo.71431","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:00:18Z","timestamp":1792659618000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal genitourinary tract infections and spontaneous preterm labor: A narrative review of pathogens, pathways, and prevention"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1743-1520","authenticated-orcid":false,"given":"Maajid Mohi Ud Din","family":"Malik","sequence":"first","affiliation":[{"name":"Dr. D.Y. Patil School of Allied Health Sciences Dr. D.Y. Patil Vidyapeeth (Deemed to be University)  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Saraf","sequence":"additional","affiliation":[{"name":"Dr. D.Y. Patil School of Allied Health Sciences Dr. D.Y. Patil Vidyapeeth (Deemed to be University)  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purnachandra Kawdu","family":"Lamghare","sequence":"additional","affiliation":[{"name":"Department of Radio\u2010Diagnosis, Dr. D.Y. Patil Medical College, Hospital and Research Centre Dr. D.Y. Patil Vidyapeeth (Deemed to be University)  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis","volume":"402","author":"Ohuma EO","year":"2023","journal-title":"Lancet"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1126\/science.1251816","article-title":"Preterm labor: one syndrome, many causes","volume":"345","author":"Romero R","year":"2014","journal-title":"Science"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1111\/aogs.70156","article-title":"Urinary tract infection during pregnancy and time relation to preterm birth\u2014a Swedish observational 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