{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:45:09Z","timestamp":1793148309069,"version":"4.5.0"},"reference-count":118,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Womens Health"],"abstract":"<jats:p>Approximately 40% of cases of spontaneous preterm birth (sPTB) are associated with ascending intrauterine infections. The cervix serves as a physical and immunological gatekeeper, preventing the ascent of microorganisms from the vagina to the amniotic cavity. The cervix undergoes remodeling during pregnancy. It remains firm and closed from the start until the late third trimester of pregnancy and then dilates and effaces to accommodate the passage of the fetus during delivery. Remodeling proceeds appropriately and timely to maintain the pregnancy until term delivery. However, risk factors, such as acute and chronic infection and local inflammation in the cervix, may compromise cervical integrity and result in premature remodeling, predisposing to sPTB. Previous clinical studies have established bacterial (i.e., chlamydia, gonorrhea, mycoplasma, etc.) and viral infections (i.e., herpesviruses and human papillomaviruses) as risk factors of PTB. However, the exact mechanism leading to PTB is still unknown. This review focuses on: (1) the epidemiology of cervical infections in pregnant patients; (2) cellular mechanisms that may explain the association of cervical infections to premature cervical ripening and PTB; (3) endogenous defense mechanisms of the cervix that protect the uterine cavity from infection and inflammation; and (4) potential inflammatory biomarkers associated with cervical infection that can serve as prognostic markers for premature cervical ripening and PTB. This review will provide mechanistic insights on cervical functions to assist in managing cervical infections during pregnancy.<\/jats:p>","DOI":"10.3389\/fgwh.2021.777643","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T04:49:34Z","timestamp":1642481374000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":43,"title":["Breaking Down the Barrier: The Role of Cervical Infection and Inflammation in Preterm Birth"],"prefix":"10.3389","volume":"2","author":[{"given":"Ourlad Alzeus G.","family":"Tantengco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramkumar","family":"Menon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"B1","article-title":"Born too soon: the global action report on preterm birth","volume-title":"World Health Organization","author":"Howson","year":"2004"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/S2214-109X(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"Chawanpaiboon","year":"2019","journal-title":"Lancet Glob Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1038\/s41372-019-0563-y","article-title":"Preterm birth and mortality in adulthood: a systematic review","volume":"40","author":"Crump","year":"2020","journal-title":"J Perinatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1001\/jamapediatrics.2019.1327","article-title":"Association of preterm birth with risk of ischemic heart disease in adulthood","volume":"173","author":"Crump","year":"2019","journal-title":"JAMA Pediatr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1503\/cmaj.150450","article-title":"Preterm birth: risk factor for early-onset chronic diseases","volume":"188","author":"Luu","year":"2016","journal-title":"Can Med Assoc J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1126\/science.1251816","article-title":"Preterm labor: one syndrome, many causes","volume":"345","author":"Romero","year":"2014","journal-title":"Science"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1007\/s00404-014-3367-5","article-title":"Would it be too late? A retrospective case-control analysis to evaluate maternal-fetal outcomes in advanced maternal age","volume":"290","author":"Ciancimino","year":"2014","journal-title":"Arch Gynecol Obstetr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s40471-017-0099-7","article-title":"Environmental chemicals and preterm birth: biological mechanisms and the state of the science","volume":"4","author":"Ferguson","year":"2017","journal-title":"Curr Epidemiol Rep."},{"key":"B9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.4103\/ijoem.IJOEM_155_16","article-title":"Occupational, environmental, and lifestyle factors and their contribution to preterm birth - an overview","volume":"21","author":"Kumar","year":"2017","journal-title":"Indian J Occup Environ Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1111\/1471-0528.13928","article-title":"Intimate partner violence during pregnancy and the risk for adverse infant outcomes: a systematic review and meta-analysis","volume":"123","author":"Donovan","year":"2016","journal-title":"BJOG Int J Obstet Gynaecol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1080\/00016340802005126","article-title":"Spontaneous preterm birth, a clinical dilemma: etiologic, pathophysiologic and genetic heterogeneities and racial disparity","volume":"87","author":"Menon","year":"2008","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B12","first-page":"343","article-title":"Etiologies of preterm birth in an indigent population: is prevention a logical expectation?","volume":"77","author":"Tucker","year":"1991","journal-title":"Obstet Gynecol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1515\/JPM.2006.073","article-title":"Guidelines for the management of spontaneous preterm labor","volume":"34","author":"di Renzo","year":"2006","journal-title":"J Perinat Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0140-6736(08)60074-4","article-title":"Epidemiology and causes of preterm birth","volume":"371","author":"Goldenberg","year":"2008","journal-title":"Lancet."},{"key":"B15","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1046\/j.1471-0528.2003.00034.x","article-title":"Infection in the prediction and antibiotics in the prevention of spontaneous preterm labour and preterm birth","volume":"110","author":"Lamont","year":"2003","journal-title":"BJOG Int J Obstetr Gynaecol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/B978-0-12-801238-3.64293-9","article-title":"Infections in pregnancy","author":"Chan","year":"2018","journal-title":"Compreh Toxicol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1056\/NEJM200005183422007","article-title":"Intrauterine infection and preterm delivery","volume":"342","author":"Goldenberg","year":"2000","journal-title":"N Engl J Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1530\/REP-07-0032","article-title":"Cervical remodeling during pregnancy and parturition: molecular characterization of the softening phase in mice","volume":"134","author":"Read","year":"2007","journal-title":"Reproduction."},{"key":"B19","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1055\/s-2006-956777","article-title":"Dynamics of cervical remodeling during pregnancy and parturition: mechanisms and current concepts","volume":"25","author":"Word","year":"2007","journal-title":"Semin Reprod Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/molehr\/6.4.375","article-title":"Human cervical ripening, an inflammatory process mediated by cytokines","volume":"6","author":"Sennstrom","year":"2000","journal-title":"Mol Hum Reprod."},{"key":"B21","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.jri.2009.12.004","article-title":"Pro-inflammatory and anti-inflammatory cytokines in human preterm and term cervical ripening","volume":"84","author":"Dubicke","year":"2010","journal-title":"J Reprod Immunol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1177\/1933719115616497","article-title":"Density of stromal cells and macrophages associated with collagen remodeling in the human cervix in preterm and term birth","volume":"23","author":"Dubicke","year":"2016","journal-title":"Reprod Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.1210\/jc.2002-021213","article-title":"Decreased type I collagen expression in human uterine cervix during pregnancy","volume":"88","author":"Iwahashi","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1095\/biolreprod.112.105049","article-title":"The recruitment and activation of leukocytes into the immune cervix: further support that cervical remodeling involves an immune and inflammatory mechanism","volume":"87","author":"Myers","year":"2012","journal-title":"Biol Reprod."},{"key":"B25","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1095\/biolreprod.102.005116","article-title":"Increased level of matrix metalloproteinases 2 and 9 in the ripening process of the human cervix","volume":"67","author":"Stygar","year":"2002","journal-title":"Biol Reprod."},{"key":"B26","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1053\/j.semperi.2017.07.014","article-title":"The pathophysiology of human premature cervical remodeling resulting in spontaneous preterm birth: where are we now?","volume":"41","author":"Vink","year":"2017","journal-title":"Semin Perinatol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1080\/00016340902852898","article-title":"The cervical mucus plug: structured review of the literature","volume":"88","author":"Becher","year":"2009","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1371\/journal.pone.0069528","article-title":"Cervical mucus properties stratify risk for preterm birth","volume":"8","author":"Critchfield","year":"2013","journal-title":"PLoS ONE."},{"key":"B29","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/aogs.12296","article-title":"The cervical mucus plug inhibits, but does not block, the passage of ascending bacteria from the vagina during pregnancy","volume":"93","author":"Hansen","year":"2014","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41467-019-14089-y","article-title":"Cervical epithelial damage promotes Ureaplasma parvum ascending infection, intrauterine inflammation and preterm birth induction in mice","volume":"11","author":"Pavlidis","year":"2020","journal-title":"Nat Commun."},{"key":"B31","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1530\/REP-10-0537","article-title":"Antimicrobial peptides and pregnancy","volume":"141","author":"Frew","year":"2011","journal-title":"Reproduction."},{"key":"B32","doi-asserted-by":"publisher","first-page":"31645","DOI":"10.3389\/fimmu.2019.03156","article-title":"Immunobiology of cervix ripening","volume":"10","author":"Yellon","year":"2020","journal-title":"Front Immunol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.tem.2010.01.011","article-title":"Cervical remodeling during pregnancy and parturition","volume":"21","author":"Timmons","year":"2010","journal-title":"Trends Endocrinol Metab."},{"key":"B34","doi-asserted-by":"publisher","first-page":"208.e1","DOI":"10.1016\/j.ajog.2011.12.036","article-title":"Inflammation promotes a cytokine response and disrupts the cervical epithelial barrier: a possible mechanism of premature cervical remodeling and preterm birth","volume":"206","author":"Nold","year":"2012","journal-title":"Am J Obstetr Gynecol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1210\/en.2010-1105","article-title":"The molecular mechanisms of cervical ripening differ between term and preterm birth","volume":"152","author":"Holt","year":"2011","journal-title":"Endocrinology."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-017-03217-7","article-title":"miR-143 and miR-145 disrupt the cervical epithelial barrier through dysregulation of cell adhesion, apoptosis and proliferation","volume":"7","author":"Anton","year":"2017","journal-title":"Sci Rep."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.3389\/fmicb.2018.02181","article-title":"Common cervicovaginal microbial supernatants alter cervical epithelial function: Mechanisms by which lactobacillus crispatus contributes to cervical health","volume":"9","author":"Anton","year":"2018","journal-title":"Front Microbiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"20190026","DOI":"10.1098\/rsfs.2019.0026","article-title":"Mechanics of cervical remodelling: insights from rodent models of pregnancy","volume":"9","author":"Yoshida","year":"2019","journal-title":"Interface Focus"},{"key":"B39","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.ajog.2011.01.003","article-title":"Cervical conization and the risk of preterm delivery","volume":"205","author":"Bevis","year":"2011","journal-title":"Am J Obstet Gynecol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s12884-018-1765-6","article-title":"Cerclage is associated with the increased risk of preterm birth in women who had cervical conization","volume":"18","author":"Cho","year":"2018","journal-title":"BMC Pregn Childb."},{"key":"B41","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/j.ajog.2004.10.624","article-title":"A short cervix in women with preterm labor and intact membranes : a risk factor for microbial invasion of the amniotic cavity","volume":"192","author":"Gomez","year":"2005","journal-title":"Am J Obstet Gynecol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"e0163793","DOI":"10.1371\/journal.pone.0163793","article-title":"Preterm Birth Prevention Post-Conization: A Model of Cervical Length Screening with Targeted Cerclage","volume":"11","author":"Kindinger","year":"2016","journal-title":"PLoS One."},{"key":"B43","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1111\/j.1542-2011.2012.00209.x","article-title":"Assessment of cervical length and the relationship between short cervix and preterm birth","volume":"57","author":"Slager","year":"2012","journal-title":"J Midwif Womens Health"},{"key":"B44","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1111\/aogs.13143","article-title":"Cervical collagen is reduced in non-pregnant women with a history of cervical insufficiency and a short cervix","volume":"96","author":"Sundtoft","year":"2017","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1093\/infdis\/jiab277","article-title":"Chlamydia, gonorrhea, and incident HIV infection during pregnancy predict preterm birth despite treatment","volume":"224","author":"Ravindran","year":"2021","journal-title":"J Infect Dis"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1781810","article-title":"Pregnancy and delivery in women with a high risk of infection in pregnancy","author":"Barinov","year":"2020","journal-title":"J MaternFetal Neonat Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1159\/000089457","article-title":"Value of endocervical Ureaplasma species colonization as a marker of preterm delivery","volume":"61","author":"Gonz\u00e1lez Bosquet","year":"2006","journal-title":"Gynecol Obstet Invest."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.12816\/0039672","article-title":"Association between chlamydia trachomatis cervicitis and preterm labor","volume":"68","author":"Mohamed","year":"2017","journal-title":"Egypt J Hosp Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/j.1447-0756.1997.tb00814.x","article-title":"Screening for bacterial vaginosis and cervicitis aimed at preventing premature delivery","volume":"23","author":"Begum","year":"1997","journal-title":"J Obstetr Gynaecol Res."},{"key":"B50","doi-asserted-by":"publisher","first-page":"325","DOI":"10.18502\/ijm.v12i4.3936","article-title":"The role of Chlamydia trachomatis in preterm delivery: a case-control study in Besat Hospital, Sanandaj, Iran (2018-2019)","volume":"12","author":"Ahmadi","year":"2020","journal-title":"Iran J Microbiol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"3160","DOI":"10.1001\/jama.1990.03440230056032","article-title":"Improved pregnancy outcome following successful treatment of chlamydial infection","volume":"263","author":"Cohen","year":"1990","journal-title":"JAMA."},{"key":"B52","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/0002-9378(90)90815-O","article-title":"Chlamydia trachomatis infection in pregnancy and effect of treatment on outcome","volume":"162","author":"Ryan","year":"1990","journal-title":"Am J Obstet Gynecol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"e0245937","DOI":"10.1371\/journal.pone.0245937","article-title":"Cervical Gardnerella vaginalis in women with preterm prelabor rupture of membranes","volume":"16","author":"Kacerovsky","year":"2021","journal-title":"PLoS ONE."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1812821","DOI":"10.1080\/19932820.2020.1812821","article-title":"The impact of Ureaplasma infections on pregnancy complications","volume":"15","author":"Bartkeviciene","year":"2020","journal-title":"Libyan J Med."},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1718575","article-title":"Inflammatory proteins in the amniotic fluid, plasma, and cervicovaginal fluid for the prediction of intra-amniotic infection\/inflammation and imminent preterm birth in preterm labor","author":"Kim","year":"2020","journal-title":"Am J Perinatol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/0028-2243(91)90185-N","article-title":"Vaginal infections, cervical ripening and preterm delivery","volume":"38","author":"Chambers","year":"1991","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7568","article-title":"Association between abnormal vaginal flora and cervical length as risk factors for preterm birth","author":"Donders","year":"2010","journal-title":"Ultrasound Obstetr Gynecol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"3621","DOI":"10.3390\/jcm9113621","article-title":"Identification of vaginal microbial communities associated with extreme cervical shortening in pregnant women","volume":"9","author":"di Paola","year":"2020","journal-title":"J Clin Med."},{"key":"B59","doi-asserted-by":"publisher","first-page":"491.e1","DOI":"10.1016\/j.ajog.2019.11.1283","article-title":"Cervicovaginal microbial communities deficient in Lactobacillus species are associated with second trimester short cervix","volume":"222","author":"Gerson","year":"2020","journal-title":"Am J Obstetr Gynecol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1038\/s41390-019-0692-1","article-title":"Lactobacilli-dominated cervical microbiota in women with preterm prelabor rupture of membranes","volume":"87","author":"Kacerovsky","year":"2020","journal-title":"Pediatr Res."},{"key":"B61","doi-asserted-by":"publisher","first-page":"2900","DOI":"10.3389\/fmicb.2019.02900","article-title":"Diverse expression of antimicrobial activities against bacterial vaginosis and urinary tract infection pathogens by cervicovaginal microbiota strains of Lactobacillus gasseri and Lactobacillus crispatus","volume":"10","author":"Atassi","year":"2019","journal-title":"Front Microbiol"},{"key":"B62","doi-asserted-by":"publisher","first-page":"564","DOI":"10.3389\/fmicb.2017.00564","article-title":"Antimicrobial compounds produced by vaginal Lactobacillus crispatus are able to strongly inhibit Candida albicans growth, hyphal formation and regulate virulence-related gene expressions","volume":"8","author":"Wang","year":"2017","journal-title":"Front Microbiol."},{"key":"B63","doi-asserted-by":"publisher","first-page":"919","DOI":"10.3389\/fcimb.2020.596917","article-title":"Lactobacillus-depleted vaginal microbiota in pregnant women living with HIV-1 infection are associated with increased local inflammation and preterm birth","volume":"10","author":"Short","year":"2021","journal-title":"Front Cell Infect Microbiol."},{"key":"B64","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1111\/cei.13558","article-title":"Cervical cytomegalovirus reactivation, cytokines and spontaneous preterm birth in Kenyan women","volume":"203","author":"Begnel","year":"2021","journal-title":"Clin Exp Immunol."},{"key":"B65","doi-asserted-by":"publisher","first-page":"385697","DOI":"10.1155\/2012\/385697","article-title":"Herpes simplex virus infection in pregnancy","volume":"2012","author":"Straface","year":"2012","journal-title":"Infect Dis Obstet Gynecol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1093\/aje\/kwu242","article-title":"Genital herpes and its treatment in relation to preterm delivery","volume":"180","author":"Li","year":"2014","journal-title":"Am J Epidemiol."},{"key":"B67","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1017\/S0950268814000636","article-title":"The prevalence and risk of human papillomavirus infection in pregnant women","volume":"142","author":"Liu","year":"2014","journal-title":"Epidemiol Infect."},{"key":"B68","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1089\/jwh.2018.7043","article-title":"Maternal human papillomavirus and preterm premature rupture of membranes: a retrospective cohort study","volume":"28","author":"Caballero","year":"2019","journal-title":"J Womens Health."},{"key":"B69","doi-asserted-by":"publisher","first-page":"129","DOI":"10.18502\/ijrm.v18i2.6433","article-title":"Human papillomavirus as a single infection in pregnant women from Northeastern Mexico: cross-sectional study TT","volume":"18","author":"Mart\u00ednez-Leal","year":"2020","journal-title":"Ijrm."},{"key":"B70","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1093\/infdis\/jiaa054","article-title":"Association between maternal human papillomavirus infection and adverse pregnancy outcomes: systematic review and meta-analysis","volume":"221","author":"Niyibizi","year":"2020","journal-title":"J Infect Dis."},{"key":"B71","doi-asserted-by":"publisher","first-page":"e1003641","DOI":"10.1371\/journal.pmed.1003641","article-title":"Associations of treated and untreated human papillomavirus infection with preterm delivery and neonatal mortality: a Swedish population-based study","volume":"18","author":"Wiik","year":"2021","journal-title":"PLoS Med."},{"key":"B72","doi-asserted-by":"publisher","first-page":"48","DOI":"10.12688\/wellcomeopenres.15140.1","article-title":"HPV infection and pre-term birth: a data-linkage study using Scottish Health Data [version 1; peer review: 3 approved]","volume":"4","author":"Aldhous","year":"2019","journal-title":"Wellcome Open Res."},{"key":"B73","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1089\/jwh.2018.7457","article-title":"Maternal history of cervical surgery and preterm delivery: a retrospective cohort study","volume":"28","author":"Wittmaack","year":"2019","journal-title":"J Womens Health."},{"key":"B74","doi-asserted-by":"publisher","first-page":"CD012847","DOI":"10.1002\/14651858.CD012847","article-title":"Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease","volume":"11","author":"Kyrgiou","year":"2017","journal-title":"Cochrane Database Syst Rev."},{"key":"B75","first-page":"266","article-title":"Pelvic scoring for elective induction","volume":"24","author":"Bishop","year":"1964","journal-title":"Obstet Gynecol."},{"key":"B76","doi-asserted-by":"publisher","first-page":"91","DOI":"10.17392\/886-16","article-title":"Correlation between cervical infection and preterm labor","volume":"14","author":"Me\u0161i\u0107 \u00d0*ogi\u0107","year":"2017","journal-title":"Medicinski Glasnik."},{"key":"B77","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/S0002-9378(99)70333-9","article-title":"Vaginitis, cervicitis, and cervical length in pregnancy","volume":"181","author":"Boomgaard","year":"1999","journal-title":"Am J Obstet Gynecol."},{"key":"B78","doi-asserted-by":"publisher","first-page":"e0191524","DOI":"10.1371\/journal.pone.0191524","article-title":"Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice","volume":"13","author":"Sierra","year":"2018","journal-title":"PLoS ONE."},{"key":"B79","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0188645","article-title":"Cervical HSV-2 infection causes cervical remodeling and increases risk for ascending infection and preterm birth","volume":"12","author":"McGee","year":"2017","journal-title":"PLoS ONE."},{"key":"B80","doi-asserted-by":"publisher","first-page":"934","DOI":"10.4049\/jimmunol.1300661","article-title":"Viral infection of the pregnant cervix predisposes to ascending bacterial infection","volume":"191","author":"Racicot","year":"2013","journal-title":"J Immunol."},{"key":"B81","doi-asserted-by":"publisher","first-page":"e21463","DOI":"10.1096\/fj.202002590RRR","article-title":"Organ-on-chip of the cervical epithelial layer: a platform to study normal and pathological cellular remodeling of the cervix","volume":"35","author":"Tantengco","year":"2021","journal-title":"FASEB J."},{"key":"B82","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.ejogrb.2008.08.009","article-title":"Cervicovaginal matrix metalloproteinase-9 and cervical ripening in human term parturition","volume":"142","author":"Choi","year":"2009","journal-title":"Eur J Obstetr Gynecol Reprod Biol."},{"key":"B83","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/S0165-0378(02)00007-4","article-title":"Inflammatory mediators and cervical ripening","volume":"57","author":"Kelly","year":"2002","journal-title":"J Reprod Immunol."},{"key":"B84","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/00006250-200103000-00015","article-title":"Cervical stroma apoptosis in pregnancy","volume":"97","author":"Allaire","year":"2001","journal-title":"Obstet Gynecol."},{"key":"B85","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1093\/biolre\/ioab058","article-title":"Oxidative stress promotes cellular damages in the cervix: implications for normal and pathologic cervical function in human pregnancy","volume":"105","author":"Tantengco","year":"2021","journal-title":"Biol Reprod."},{"key":"B86","doi-asserted-by":"publisher","first-page":"e13370","DOI":"10.1111\/aji.13370","article-title":"Effects of a gestational level of estradiol on cellular transition, migration, and inflammation in cervical epithelial and stromal cells","volume":"85","author":"Tantengco","year":"2021","journal-title":"Am J Reprod Immunol."},{"key":"B87","doi-asserted-by":"publisher","first-page":"111276","DOI":"10.1016\/j.mce.2021.111276","article-title":"Progesterone alters human cervical epithelial and stromal cell transition and migration: Implications in cervical remodeling during pregnancy and parturition","volume":"529","author":"Tantengco","year":"2021","journal-title":"Mol Cell Endocrinol."},{"key":"B88","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s00441-018-02983-8","article-title":"Mechanobiology of mice cervix: expression profile of mechano-related molecules during pregnancy","volume":"376","author":"Gordon","year":"2019","journal-title":"Cell Tissue Res."},{"key":"B89","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.3109\/14767050903353216","article-title":"The transcriptome of cervical ripening in human pregnancy before the onset of labor at term: identification of novel molecular functions involved in this process","volume":"22","author":"Hassan","year":"2009","journal-title":"J Matern Fetal Neonat Med."},{"key":"B90","doi-asserted-by":"publisher","first-page":"e0250108","DOI":"10.1371\/journal.pone.0250108","article-title":"Changes in gene expression of cervical collagens, metalloproteinases, and tissue inhibitors of metalloproteinases after partial cervical excision-induced preterm labor in mice","volume":"16","author":"Jeong","year":"2021","journal-title":"PLoS ONE."},{"key":"B91","doi-asserted-by":"publisher","first-page":"11246","DOI":"10.1038\/s41598-019-47756-7","article-title":"Predictive value of cervical cytokine, antimicrobial and microflora levels for pre-term birth in high-risk women","volume":"9","author":"Manning","year":"2019","journal-title":"Sci Rep."},{"key":"B92","doi-asserted-by":"publisher","first-page":"100092","DOI":"10.1016\/j.ajogmf.2020.100092","article-title":"Maternal stress, low cervicovaginal \u03b2-defensin, and spontaneous preterm birth","volume":"2","author":"Burris","year":"2020","journal-title":"Am J Obstetr Gynecol MFM."},{"key":"B93","doi-asserted-by":"publisher","first-page":"106","DOI":"10.3389\/fimmu.2020.00106","article-title":"Cervical gene delivery of the antimicrobial peptide, Human \u03b2-Defensin (HBD)-3, in a mouse model of ascending infection-related preterm birth","volume":"11","author":"Suff","year":"2020","journal-title":"Front Immunol."},{"key":"B94","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1067\/mob.2001.116685","article-title":"An in vitro study of antibacterial properties of the cervical mucus plug in pregnancy","volume":"185","author":"Hein","year":"2001","journal-title":"Am J Obstet Gynecol."},{"key":"B95","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1067\/mob.2002.123034","article-title":"Antimicrobial factors in the cervical mucus plug","volume":"187","author":"Hein","year":"2002","journal-title":"Am J Obstetr Gynecol."},{"key":"B96","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/0028-2243(94)02023-8","article-title":"Secretory leukocyte protease inhibitor in the cervical mucus and in the fetal membranes","volume":"59","author":"Helmig","year":"1995","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B97","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1093\/infdis\/jiy076","article-title":"Human cervical mucus plugs exhibit insufficiencies in antimicrobial activity towards group B Streptococcus","volume":"217","author":"Vornhagen","year":"2018","journal-title":"J Infect Dis."},{"key":"B98","first-page":"43","volume":"4","author":"Dolgushin","year":"2004","journal-title":"Zhurnal Mikrobiologii, Epidemiologii i Immunobiologii"},{"key":"B99","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1034\/j.1600-0412.1998.770701.x","article-title":"IL-1beta, IL-6, TNFalpha, fetal fibronectin, and endotoxin in the lower genital tract of pregnant women with bacterial vaginosis","volume":"77","author":"Mattsby-Baltzer","year":"1998","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B100","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.ijgo.2005.10.004","article-title":"Cervical inflammatory cytokines and other markers in the cervical mucus of pregnant women with lower genital tract infection","volume":"92","author":"Sawada","year":"2006","journal-title":"Int J Gynaecol Obstet."},{"key":"B101","doi-asserted-by":"publisher","first-page":"342075","DOI":"10.5402\/2012\/342075","article-title":"Evaluation of cytokines in endocervical secretion and vaginal ph from women with bacterial vaginosis or human papillomavirus","volume":"2012","author":"Campos","year":"2012","journal-title":"ISRN Obstet Gynecol."},{"key":"B102","doi-asserted-by":"publisher","first-page":"7693183","DOI":"10.1155\/2019\/7693183","article-title":"Immunity in the cervix: interphase between immune and cervical epithelial cells","volume":"2019","author":"de Tomasi","year":"2019","journal-title":"J Immunol Res."},{"key":"B103","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1136\/sti.77.5.366","article-title":"Macrophages are increased in cervical epithelium of women with cervicitis","volume":"77","author":"Prakash","year":"2001","journal-title":"Sex Transm Infect."},{"key":"B104","first-page":"671","article-title":"Enhanced immunocompetent cells in chlamydial cervicitis","volume":"49","author":"Mittal","year":"2004","journal-title":"J Reprod Med."},{"key":"B105","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jri.2010.06.155","article-title":"Intravaginal infection with herpes simplex virus type-2 (HSV-2) generates a functional effector memory T cell population that persists in the murine genital tract","volume":"87","author":"Tang","year":"2010","journal-title":"J Reprod Immunol."},{"key":"B106","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1038\/nm.2006","article-title":"Persistence of HIV-1 receptor-positive cells after HSV-2 reactivation is a potential mechanism for increased HIV-1 acquisition","volume":"15","author":"Zhu","year":"2009","journal-title":"Nat Med."},{"key":"B107","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14767058.2020.1869932","article-title":"Intra-amniotic infection and sterile intra-amniotic inflammation are associated with elevated concentrations of cervical fluid interleukin-6 in women with spontaneous preterm labor with intact membranes","author":"Stranik","year":"2021","journal-title":"J Matern Fetal Neonat Med."},{"key":"B108","first-page":"150","article-title":"Ultrasonographic and biochemical markers of preterm labor","volume":"8","author":"Rizzo","year":"1998","journal-title":"J Matern Fetal Invest."},{"key":"B109","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s11306-016-0985-x","article-title":"Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy","volume":"12","author":"Amabebe","year":"2016","journal-title":"Metabolomics."},{"key":"B110","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1007\/s00404-020-05560-z","article-title":"Complement and other immune-related factors in cervicovaginal fluid associated with intra-amniotic infection\/inflammation and spontaneous preterm delivery in women with preterm labor","volume":"301","author":"Hong","year":"2020","journal-title":"Arch Gynecol Obstet."},{"key":"B111","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1007\/s43032-020-00143-4","article-title":"Identification of cultivable bacteria in amniotic fluid using cervicovaginal fluid protein microarray in preterm premature rupture of membranes","volume":"27","author":"Lee","year":"2020","journal-title":"Reprod Sci."},{"key":"B112","doi-asserted-by":"publisher","first-page":"6107","DOI":"10.1038\/s41598-021-85473-2","article-title":"IgGFc-binding protein in pregnancies complicated by spontaneous preterm delivery: a retrospective cohort study","volume":"11","author":"Stranik","year":"2021","journal-title":"Sci Rep."},{"key":"B113","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1002\/ijgo.13512","article-title":"Evaluation of trappin-2 in cervicovaginal secretions as predictor of spontaneous preterm birth in asymptomatic high-risk women: nested case-control study","volume":"154","author":"Negi","year":"2021","journal-title":"Int J Gynecol Obstetr."},{"key":"B114","doi-asserted-by":"publisher","first-page":"48","DOI":"10.3389\/fmed.2016.00048","article-title":"cervicovaginal fluid acetate: a metabolite marker of preterm birth in symptomatic pregnant women","volume":"3","author":"Amabebe","year":"2016","journal-title":"Front Med."},{"key":"B115","doi-asserted-by":"publisher","first-page":"e0211595","DOI":"10.1371\/journal.pone.0211595","article-title":"Current status of Neisseria gonorrhoeae cervicitis in pregnant women in Japan","volume":"14","author":"Suzuki","year":"2019","journal-title":"PLoS ONE."},{"key":"B116","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR. Recommend Rep."},{"key":"B117","doi-asserted-by":"publisher","first-page":"S102","DOI":"10.1086\/511423","article-title":"Management of women with cervicitis","volume":"44","author":"Marrazzo","year":"2007","journal-title":"Clin Infect Dis."},{"key":"B118","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.idc.2008.05.003","article-title":"Prevention of sexually transmitted infections in women","volume":"22","author":"Piper","year":"2008","journal-title":"Infect Dis Clin North Am."}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2021.777643\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T04:49:47Z","timestamp":1642481387000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2021.777643\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,18]]},"references-count":118,"alternative-id":["10.3389\/fgwh.2021.777643"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2021.777643","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,18]]},"article-number":"777643"}}