{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:12:46Z","timestamp":1783660366673,"version":"3.55.0"},"reference-count":76,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This systematic review assessed transcriptomic evidence on the molecular mechanisms underlying spontaneous preterm birth (sPTB). Major electronic databases were searched from inception to October 2025. Eligible studies examined RNA transcriptomic profiles from maternal pregnancy-related tissues or biofluids in spontaneous preterm labor (sPTL) or preterm prelabor rupture of membranes (PPROM), while indicated or iatrogenic preterm births were excluded. Two reviewers independently screened studies, extracted differentially expressed genes (DEGs), and assessed study quality. DEGs were summarized by tissue type, and recurrent concordant genes were analyzed using Gene Ontology, Reactome, and Kyoto Encyclopedia of Genes and Genomes enrichment analyses, with false discovery rate &lt; 0.05 considered significant. Twenty studies were included. Transcriptomic data were derived from placental villi, maternal peripheral blood, decidua, fetal membranes, myometrium, amniotic fluid, and vaginal secretions. Placental villi findings suggested proliferative-metabolic reprogramming and impaired maternal\u2013fetal immune\u2013structural homeostasis, whereas maternal blood profiles reflected systemic immune\u2013inflammatory activation and dysregulated lipid-metabolic pathways. sPTL and PPROM showed potentially distinct signatures involving extracellular matrix disruption, collagen remodeling, matrix degradation, and myeloid\/neutrophil-associated inflammation. Transcriptomic profiling may support non-invasive sPTB risk assessment, but standardized, phenotype-specific longitudinal studies are needed to confirm predictive value and clinical utility.<\/jats:p>","DOI":"10.3390\/ijms27136006","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:43:14Z","timestamp":1783345394000},"page":"6006","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Molecular Mechanism and Pathways of Spontaneous Preterm Birth in Different Gestational Tissues: A Systematic Review of Transcriptome Studies"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1744-1702","authenticated-orcid":false,"given":"Yue","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2733-8939","authenticated-orcid":false,"given":"Hillary Hiu Yu","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5042-4731","authenticated-orcid":false,"given":"Annie Shuk Yi","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-0343","authenticated-orcid":false,"given":"Tak Yeung","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"ref_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","year":"2023","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","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":"ref_3","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1053\/j.semperi.2017.07.009","article-title":"Epidemiology of preterm birth","volume":"41","author":"Purisch","year":"2017","journal-title":"Semin. Perinatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1080\/14767050600965882","article-title":"Epidemiology of preterm birth and its clinical subtypes","volume":"19","author":"Ananth","year":"2006","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.ijgo.2014.06.019","article-title":"Trends in preterm birth in singleton deliveries in a Hong Kong population","volume":"127","author":"Hui","year":"2014","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"eabc8696","DOI":"10.1126\/sciadv.abc8696","article-title":"Transcriptome and regulatory maps of decidua-derived stromal cells inform gene discovery in preterm birth","volume":"6","author":"Sakabe","year":"2020","journal-title":"Sci. Adv."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Vidal, M.S., Lintao, R.C.V., Severino, M.E.L., Tantengco, O.A.G., and Menon, R. (2022). Spontaneous preterm birth: Involvement of multiple feto-maternal tissues and organ systems, differing mechanisms, and pathways. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1015622"},{"key":"ref_8","doi-asserted-by":"crossref","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":"ref_9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3390\/reprodmed3020009","article-title":"Inflammation and Preterm Birth: A Systematic Review","volume":"3","author":"Areia","year":"2022","journal-title":"Reprod. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Pereyra, S., Sosa, C., Bertoni, B., and Sapiro, R. (2019). Transcriptomic analysis of fetal membranes reveals pathways involved in preterm birth. BMC Med. Genom., 12.","DOI":"10.1186\/s12920-019-0498-3"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Cunningham, S.J., Feng, L., Allen, T.K., and Reddy, T.E. (2020). Functional Genomics of Healthy and Pathological Fetal Membranes. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00687"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"462.e1","DOI":"10.1016\/j.ajog.2010.02.045","article-title":"Characterization of the transcriptome of chorioamniotic membranes at the site of rupture in spontaneous labor at term","volume":"202","author":"Romero","year":"2010","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"73.e1","DOI":"10.1016\/j.ajog.2022.07.015","article-title":"Placental transcriptomic signatures of spontaneous preterm birth","volume":"228","author":"Paquette","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.placenta.2022.03.122","article-title":"Integrated analysis of transcriptomic datasets to identify placental biomarkers of spontaneous preterm birth","volume":"122","author":"Sobhani","year":"2022","journal-title":"Placenta"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100323","DOI":"10.1016\/j.xcrm.2021.100323","article-title":"Crowdsourcing assessment of maternal blood multi-omics for predicting gestational age and preterm birth","volume":"2","author":"Tarca","year":"2021","journal-title":"Cell Rep. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1515\/jpm.2010.097","article-title":"Characterization of the myometrial transcriptome and biological pathways of spontaneous human labor at term","volume":"38","author":"Mittal","year":"2010","journal-title":"J. Perinat. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Stanfield, Z., Lai, P.F., Lei, K., Johnson, M.R., Blanks, A.M., Romero, R., Chance, M.R., Mesiano, S., and Koyut\u00fcrk, M. (2019). Myometrial Transcriptional Signatures of Human Parturition. Front. Genet., 10, Erratum in Front. Genet.\u00a02019, 10, 515.","DOI":"10.3389\/fgene.2019.00185"},{"key":"ref_18","first-page":"e153921","article-title":"A single-cell atlas of the myometrium in human parturition","volume":"7","author":"Romero","year":"2022","journal-title":"J. Clin. Investig."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1023","DOI":"10.1002\/ctm2.1023","article-title":"Microbial and human transcriptome in vaginal fluid at midgestation: Association with spontaneous preterm delivery","volume":"12","author":"Abrahamsson","year":"2022","journal-title":"Clin. Transl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Eidem, H.R., Ackerman, W.E., McGary, K.L., Abbot, P., and Rokas, A. (2015). Gestational tissue transcriptomics in term and preterm human pregnancies: A systematic review and meta-analysis. BMC Med. Genom., 8.","DOI":"10.1186\/s12920-015-0099-8"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Vora, B., Wang, A., Kosti, I., Huang, H., Paranjpe, I., Woodruff, T.J., MacKenzie, T., and Sirota, M. (2018). Meta-Analysis of Maternal and Fetal Transcriptomic Data Elucidates the Role of Adaptive and Innate Immunity in Preterm Birth. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.00993"},{"key":"ref_22","first-page":"100118","article-title":"Blood gene transcript signature profiling in pregnancies resulting in preterm birth: A systematic review","volume":"8","author":"Brummaier","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol. X"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1055\/s-0039-1678717","article-title":"RNA-Sequencing of Umbilical Cord Blood to Investigate Spontaneous Preterm Birth: A Pilot Study","volume":"9","author":"Vora","year":"2019","journal-title":"Am. J. Perinatol. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1186\/s12967-023-04083-w","article-title":"Identification of novel cell-free RNAs in maternal plasma as preterm biomarkers in combination with placental RNA profiles","volume":"21","author":"Jin","year":"2023","journal-title":"J. Transl. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wang, T., Sun, L., Li, M., Zhang, Y., and Huang, L. (2025). Transcriptomics reveals preterm birth risk: Identification and validation of key genes in monocytes. BMC Pregnancy Childbirth, 25.","DOI":"10.1186\/s12884-025-07293-w"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e00819-20","DOI":"10.1128\/IAI.00819-20","article-title":"RNA Sequencing Reveals Distinct Immune Responses in the Chorioamniotic Membranes of Women with Preterm Labor and Microbial or Sterile Intra-amniotic Inflammation","volume":"89","author":"Motomura","year":"2021","journal-title":"Infect. Immun."},{"key":"ref_27","first-page":"20","article-title":"Whole-transcriptome analysis of maternal blood for identification of RNA markers for predicting spontaneous preterm birth among preterm labour women: Abridged secondary publication","volume":"26","author":"Chim","year":"2020","journal-title":"Hong Kong Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1093\/biolre\/ioaf085","article-title":"Race and sex differences in placental lipid metabolism are associated with spontaneous early preterm birth","volume":"113","author":"Lien","year":"2025","journal-title":"Biol. Reprod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1177\/1933719115612925","article-title":"Candidate Gene and MicroRNA Expression in Fetal Membranes and Preterm Delivery Risk","volume":"23","author":"Enquobahrie","year":"2016","journal-title":"Reprod. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"106.e1","DOI":"10.1016\/j.ajog.2021.07.002","article-title":"Preterm labor is a distinct process from term labor following computational analysis of human myometrium","volume":"226","author":"Phung","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Richardson, L.S., Severino, M.E., Chauhan, R., Zhang, W., Kacerovsky, M., Bhavnani, S.K., and Menon, R. (2024). Spatial transcriptomics of fetal membrane\u2014Decidual interface reveals unique contributions by cell types in term and preterm births. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0309063"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e1234","DOI":"10.1002\/ctm2.1234","article-title":"Integrating single-cell RNA sequencing with spatial transcriptomics reveals an immune landscape of human myometrium during labour","volume":"13","author":"Ji","year":"2023","journal-title":"Clin. Transl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1126\/science.aar3819","article-title":"Noninvasive blood tests for fetal development predict gestational age and preterm delivery","volume":"360","author":"Ngo","year":"2018","journal-title":"Science"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e3685","DOI":"10.7717\/peerj.3685","article-title":"Onset of human preterm and term birth is related to unique inflammatory transcriptome profiles at the maternal fetal interface","volume":"5","author":"Bukowski","year":"2017","journal-title":"PeerJ"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Enquobahrie, D.A., Williams, M.A., Qiu, C., Muhie, S.Y., Slentz-Kesler, K., Ge, Z., and Sorenson, T. (2009). Early pregnancy peripheral blood gene expression and risk of preterm delivery: A nested case control study. BMC Pregnancy Childbirth, 9.","DOI":"10.1186\/1471-2393-9-56"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"330.e1","DOI":"10.1016\/j.ajog.2022.08.036","article-title":"Preterm labor with and without chorioamnionitis is associated with activation of myometrial inflammatory networks: A comprehensive transcriptomic analysis","volume":"228","author":"Phung","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/1933719109353454","article-title":"Molecular Markers of Preterm Labor in the Choriodecidua","volume":"17","author":"Shankar","year":"2010","journal-title":"Reprod. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Kamath-Rayne, B.D., Du, Y., Hughes, M., Wagner, E.A., Muglia, L.J., DeFranco, E.A., Whitsett, J.A., Salomonis, N., and Xu, Y. (2015). Systems biology evaluation of cell-free amniotic fluid transcriptome of term and preterm infants to detect fetal maturity. BMC Med. Genom., 8.","DOI":"10.1186\/s12920-015-0138-5"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tarca, A.L., Romero, R., Pique-Regi, R., Pacora, P., Done, B., Kacerovsky, M., Bhatti, G., Jaiman, S., Hassan, S.S., and Hsu, C.-D. (2020). Amniotic fluid cell-free transcriptome: A glimpse into fetal development and placental cellular dynamics during normal pregnancy. BMC Med. Genom., 13.","DOI":"10.1186\/s12920-020-0690-5"},{"key":"ref_40","first-page":"e148425","article-title":"Molecular signatures of labor and nonlabor myometrium with parsimonious classification from 2 calcium transporter genes","volume":"6","author":"Ackerman","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Chim, S.S.C., Lee, W.S., Ting, Y.H., Chan, O.K., Lee, S.W.Y., and Leung, T.Y. (2012). Systematic Identification of Spontaneous Preterm Birth-Associated RNA Transcripts in Maternal Plasma. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0034328"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Brockway, H.M., Kallapur, S.G., Buhimschi, I.A., Buhimschi, C.S., Ackerman, W.E., Muglia, L.J., and Jones, H.N. (2019). Unique transcriptomic landscapes identified in idiopathic spontaneous and infection related preterm births compared to normal term births. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0225062"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Lien, Y.-C., Zhang, Z., Cheng, Y., Polyak, E., Sillers, L., Falk, M.J., Ischiropoulos, H., Parry, S., and Simmons, R.A. (2021). Human Placental Transcriptome Reveals Critical Alterations in Inflammation and Energy Metabolism with Fetal Sex Differences in Spontaneous Preterm Birth. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22157899"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"332.e1","DOI":"10.1016\/j.ajog.2022.08.035","article-title":"Proinflammatory changes in the maternal circulation, maternal\u2013fetal interface, and placental transcriptome in preterm birth","volume":"228","author":"Couture","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Akram, K.M., Kulkarni, N.S., Brook, A., Wyles, M.D., and Anumba, D.O.C. (2022). Transcriptomic analysis of the human placenta reveals trophoblast dysfunction and augmented Wnt signalling associated with spontaneous preterm birth. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.987740"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1093\/molehr\/gax038","article-title":"Immune cell and transcriptomic analysis of the human decidua in term and preterm parturition","volume":"23","author":"Rinaldi","year":"2017","journal-title":"Mol. Hum. Reprod."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Arrowsmith, S., Fang, Y., and Sharp, A. (2020). Comparison of the myometrial transcriptome from singleton and twin pregnancies by RNA-Seq. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227882"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"13481","DOI":"10.1038\/s41598-021-92439-x","article-title":"The amniotic fluid cell-free transcriptome in spontaneous preterm labor","volume":"11","author":"Bhatti","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Heng, Y.J., Pennell, C.E., Chua, H.N., Perkins, J.E., and Lye, S.J. (2014). Whole Blood Gene Expression Profile Associated with Spontaneous Preterm Birth in Women with Threatened Preterm Labor. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0096901"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"345.e1","DOI":"10.1016\/j.ajog.2017.12.234","article-title":"Comparative analysis of gene expression in maternal peripheral blood and monocytes during spontaneous preterm labor","volume":"218","author":"Paquette","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1038\/s41598-021-81834-z","article-title":"Integrative analysis of transcriptomic data for identification of T-cell activation-related mRNA signatures indicative of preterm birth","volume":"11","author":"Yoo","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Heng, Y.J., Pennell, C.E., McDonald, S.W., Vinturache, A.E., Xu, J., Lee, M.W.F., Briollais, L., Lyon, A.W., Slater, D.M., and Bocking, A.D. (2016). Maternal Whole Blood Gene Expression at 18 and 28 Weeks of Gestation Associated with Spontaneous Preterm Birth in Asymptomatic Women. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155191"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1111\/1471-0528.16736","article-title":"Early pregnancy prediction of spontaneous preterm birth before 32 completed weeks of pregnancy using plasma RNA: Transcriptome discovery and initial validation of an RNA panel of markers","volume":"128","author":"Weiner","year":"2021","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1038\/s41598-022-04881-0","article-title":"Genome and transcriptome profiling of spontaneous preterm birth phenotypes","volume":"12","author":"Gupta","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"72.e1","DOI":"10.1016\/j.ajog.2022.04.002","article-title":"Predictive RNA profiles for early and very early spontaneous preterm birth","volume":"227","author":"Gee","year":"2022","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"602.e1","DOI":"10.1016\/j.ajog.2017.02.009","article-title":"The preterm cervix reveals a transcriptomic signature in the presence of premature prelabor rupture of membranes","volume":"216","author":"Makieva","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Underhill, L.A., Mennella, J.M., Tollefson, G.A., Uzun, A., and Lechner, B.E. (2024). Transcriptomic analysis delineates preterm prelabor rupture of membranes from preterm labor in preterm fetal membranes. BMC Med. Genom., 17.","DOI":"10.1186\/s12920-024-01841-7"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/aji.12258","article-title":"Toll-like Receptors at the Maternal-Fetal Interface in Normal Pregnancy and Pregnancy Complications","volume":"72","author":"Koga","year":"2014","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jri.2010.12.003","article-title":"The role of the Nod-like receptor family in trophoblast innate immune responses","volume":"88","author":"Abrahams","year":"2011","journal-title":"J. Reprod. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e1121","DOI":"10.1002\/cti2.1121","article-title":"Targeting Toll-like receptor-4 to tackle preterm birth and fetal inflammatory injury","volume":"9","author":"Robertson","year":"2020","journal-title":"Clin. Transl. Immunol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Padron, J.G., Reis, C.A.S., and Kendal-Wright, C.E. (2020). The Role of Danger Associated Molecular Patterns in Human Fetal Membrane Weakening. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00602"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Griesenauer, B., and Paczesny, S. (2017). The ST2\/IL-33 Axis in Immune Cells during Inflammatory Diseases. Front. Immunol., 8.","DOI":"10.3389\/fimmu.2017.00475"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2551","DOI":"10.4049\/jimmunol.179.4.2551","article-title":"IL-1 Receptor Accessory Protein and ST2 Comprise the IL-33 Receptor Complex","volume":"179","author":"Chackerian","year":"2007","journal-title":"J. Immunol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1002\/jlb.63.6.650","article-title":"Signal transduction pathways activated by the IL-1 receptor family: Ancient signaling machinery in mammals, insects, and plants","volume":"63","author":"Greene","year":"1998","journal-title":"J. Leukoc. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2944","DOI":"10.1111\/febs.14466","article-title":"A guide to chemokines and their receptors","volume":"285","author":"Hughes","year":"2018","journal-title":"FEBS J."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1038\/cmi.2014.46","article-title":"Immune cells in term and preterm labor","volume":"11","author":"Stlouis","year":"2014","journal-title":"Cell. Mol. Immunol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1152\/physrev.00019.2023","article-title":"The hormonal control of parturition","volume":"104","author":"Mesiano","year":"2024","journal-title":"Physiol. Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.cytogfr.2024.07.007","article-title":"Inflammatory mechanisms of preterm labor and emerging anti-inflammatory interventions","volume":"78","author":"Habelrih","year":"2024","journal-title":"Cytokine Growth Factor Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/1933719111424454","article-title":"Extracellular Matrix Dynamics and Fetal Membrane Rupture","volume":"20","author":"Strauss","year":"2013","journal-title":"Reprod. Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"S121","DOI":"10.1016\/j.ejogrb.2009.02.014","article-title":"Biomechanics of the fetal membrane prior to mechanical failure: Review and implications","volume":"144","author":"Joyce","year":"2009","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/molehr\/gav074","article-title":"Oxidative stress damage-associated molecular signaling pathways differentiate spontaneous preterm birth and preterm premature rupture of the membranes","volume":"22","author":"Dutta","year":"2015","journal-title":"Mol. Hum. Reprod."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1016\/j.ajpath.2014.02.011","article-title":"Histological Evidence of Oxidative Stress and Premature Senescence in Preterm Premature Rupture of the Human Fetal Membranes Recapitulated in Vitro","volume":"184","author":"Menon","year":"2014","journal-title":"Am. J. Pathol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Bautista-Bautista, G., Salguero-Zacarias, S., Villeda-Gabriel, G., Garc\u00eda-L\u00f3pez, G., Osorio-Caballero, M., Palafox-Vargas, M.L., Acu\u00f1a-Gonz\u00e1lez, R.J., Lara-Pereyra, I., D\u00edaz-Ru\u00edz, O., and Flores-Herrera, H. (2024). Escherichia coli induced matrix metalloproteinase-9 activity and type IV collagen degradation is regulated by progesterone in human maternal decidual. BMC Pregnancy Childbirth, 24.","DOI":"10.1186\/s12884-024-06847-8"},{"key":"ref_75","first-page":"1313","article-title":"Prolactin Protects the Structural Integrity of Human Fetal Membranes by Downregulating Inflammation-induced Secretion of Matrix Metalloproteinases","volume":"51","year":"2021","journal-title":"Immunol. Investig."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e13642","DOI":"10.1111\/aji.13642","article-title":"Matrix metalloproteinases in preterm prelabor rupture of membranes in the setting of chorioamnionitis: A scoping review","volume":"89","author":"Nguyen","year":"2022","journal-title":"Am. J. Reprod. Immunol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/6006\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:13:12Z","timestamp":1783656792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/6006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,4]]},"references-count":76,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijms27136006"],"URL":"https:\/\/doi.org\/10.3390\/ijms27136006","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,4]]}}}