Reductionist and system approaches to study the role of infection in preterm labor and delivery

Piotr Laudanski,Piotr Pierzynski,Tadeusz Laudanski

doi:10.1186/1471-2393-7-s1-s9

Abstract

A substantial number of patients with preterm labor and delivery do not show clinical signs of infection, however, it is the subclinical form which is the main causative factor and often results in premature delivery. The hitherto commonly applied methods of inflammation detection are based either on potentially hazardous amniocentesis or still insufficient inflammation-related protein measurement in the serum or other biological fluids.The advent of new "omics" technologies has led to a paradigm-shift in experimental approach which tends to primarily generate rather than form hypotheses. This has resulted in a surge of wealth of data composed of sets of individual or clusters of new genes and proteins that can be of potential importance as new markers of inflammation leading to preterm labor. It is hoped that as a result of those new methodologies the overall perception of medical research and practice would gradually change from reductionist to systems approach. Despite several successes of reductionism in the diagnosis and treatment of preterm labor it seems that system-based methodology would contribute to a more favorable personalized rather than one-for-all patient assistance. In this review we present the current knowledge on this new attractive field of medical studies with emphasis on early detection of infection related with preterm labor.

Highlights

Preterm birth is the ultimate result of several different pathways that culminate in the initiation of labor before 37 weeks' gestation
Significant disparities in preterm birth rates exist between racial and ethnic groups according to most recent Institute of Medicine report on preterm birth [4]
It may be due to a number of factors such as: nutrition, cigarette smoking, substance use or abuse, work and physical activity, prenatal care or infection, it is most feasible that cultural and sociological factors are mainly responsible for the increase in preterm birth rates in the past decade

Summary

Introduction

Preterm birth is the ultimate result of several different pathways that culminate in the initiation of labor before 37 weeks' gestation. There are many examples in general medicine, in obstetrical diseases including preterm labor, where reductionism by means of focusing on a single factors and/or events is tremendously helpful and efficient as a way to study pathogenesis as well as search of new biomarkers It can among others be exemplified by the positive results on tests of vaginal secretions for bacterial vaginosis (defined as a decrease in the normally occurring Lactobacillus species and a massive increase in other organisms) http://www.biomedcentral.com/1471-2393/7/S1/S9 which were found to be associated with intrauterine infection and were sufficient to predict preterm delivery [14]. In one of the first microarray studies on preterm delivery, Marvin et al used cytokine-specific 384 gene array to compare expression level of term and preterm gestational membranes

Conclusion

Findings

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