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The GM is a highly angiogenic, protease-active developmental niche that operates near the limits of vascular stability under tightly regulated intrauterine conditions. Preterm birth disrupts this balance by removing late-gestational immune modulation and exposing protease-primed GM vessels to exaggerated inflammatory activation. Dysregulated innate immune responses amplify endothelial junctional cleavage and basement-membrane degradation and reprogram the local myeloid environment toward neutrophil-derived protease release. We propose a unified protease-threshold framework in which GMH occurs when inflammatory amplification drives proteolytic activity beyond the structural resilience of the immature GM vasculature. 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