{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:09:34Z","timestamp":1793945374993,"version":"4.8.0"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Preterm birth remains an important global problem, and an important contributor to under-5 mortality. Reducing spontaneous preterm birth rates at the global level will require the early identification of patients at risk of preterm delivery in order to allow the initiation of appropriate prophylactic management strategies. Ideally these strategies target the underlying pathophysiologic causes of preterm labor. Prevention, however, becomes problematic as the causes of preterm birth are multifactorial and vary by gestational age, ethnicity, and social context. Unfortunately, current screening and diagnostic tests are non-specific, with only moderate clinical risk prediction, relying on the detection of downstream markers of the common end-stage pathway rather than identifying upstream pathway-specific pathophysiology that would help the provider initiate targeted interventions. As a result, the available management options (including cervical cerclage and vaginal progesterone) are used empirically with, at best, ambiguous results in clinical trials. Furthermore, the available screening tests have only modest clinical risk prediction, and fail to identify most patients who will have a preterm birth. Clearly defining preterm birth phenotypes and the biologic pathways leading to preterm birth is key to providing targeted, biomolecular pathway-specific interventions, ideally initiated in early pregnancy Pathway specific biomarker discovery, together with management strategies based on early, mid-, and-late trimester specific markers is integral to this process, which must be addressed in a systematic way through rigorously planned biomarker trials.<\/jats:p>","DOI":"10.3389\/fmed.2024.1414428","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T14:46:18Z","timestamp":1722005178000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":21,"title":["Assessment of current biomarkers and interventions to identify and treat women at risk of preterm birth"],"prefix":"10.3389","volume":"11","author":[{"given":"Michael G.","family":"Gravett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramkumar","family":"Menon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Tribe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha L.","family":"Hezelgrave","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Kacerovsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Soma-Pillay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Jacobsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F.","family":"McElrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"ref1","volume-title":"Stratified, personalised or P4 medicine: a new direction for placing the patient at the Centre of healthcare and health education (technical report)Academy of Medical Sciences","year":"2015"},{"key":"ref2","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":"ref3","doi-asserted-by":"publisher","first-page":"262sr5","DOI":"10.1126\/scitranslmed.3009871","article-title":"Prevention of preterm birth: harnessing science to address the global epidemic","volume":"6","author":"Rubens","year":"2014","journal-title":"Sci Transl Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.ajog.2011.10.864","article-title":"Challenges in defining and classifying the preterm birth syndrome","volume":"206","author":"Kramer","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1111\/j.1471-0528.1997.tb11495.x","article-title":"The diagnostic accuracy of cervico-vaginal fetal fibronectin in predicting preterm delivery: an overview","volume":"104","author":"Chien","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"CD007235","DOI":"10.1002\/14651858.CD007235.pub4","article-title":"Cervical assessment by ultrasound for preventing preterm delivery","volume":"2019","author":"Berghella","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1111\/1471-0528.16519","article-title":"Second-trimester transvaginal ultrasound measurement of cervical length for prediction of preterm birth: a blinded prospective multicentre diagnostic accuracy study","volume":"128","author":"Kuusela","year":"2021","journal-title":"BJOG"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e0162506","DOI":"10.1371\/journal.pone.0162506","article-title":"Cross-country individual participant analysis of 4.1 million singleton births in 5 countries with very high human development index confirms known associations but provides no biologic explanation for 2\/3 of all preterm births","volume":"11","author":"Ferrero","year":"2016","journal-title":"PLoS One"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1097\/AOG.0b013e318184181a","article-title":"Estimating recurrence of spontaneous preterm delivery","volume":"112","author":"Esplin","year":"2008","journal-title":"Obstet Gynecol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1016\/s0002-9378(99)70111-0","article-title":"The preterm prediction study: effect of gestational age and cause of preterm birth on subsequent obstetric outcome. 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