ArticleAmerican journal of obstetrics and gynecology2015
Uterine overdistention induces preterm labor mediated by inflammation: observations in pregnant women and nonhuman primates.
Article in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 1 of them a synthesis that pooled it.
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Who cites it
93 citing papers in PubMed, 1 synthesis or guideline pooled it, 163 citations in OpenAlex.
- Cervical pessary to prevent preterm birth in asymptomatic high-risk women: a systematic review and meta-analysis.American journal of obstetrics and gynecology · 2020Pooled it
- A single-cell transcriptomic atlas of the pigtail macaque placenta in late gestation.BMC genomics · 2026Article
- A Comprehensive Study of Uterine Muscle Activity During the Third Trimester: Comparison of Singleton and Multiple Gestations.IEEE journal of translational engineering in health and medicine · 2026Article
- Myometrial mechanotransduction and the timing of parturition: ion-channel pathways linking uterine stretch, calcium signaling, and inflammation.Frontiers in physiology · 2026Review
- The Role of Biomechanical Regulation in Physiological and Pathological Pregnancy: From Mechanotransduction to Clinical Implications.International journal of biological sciences · 2026Review
- Esophageal Atresia: From worry to wisdom-Global pediatrics · 2025Article
- Monocytes at the crossroads of inflammation and labor: biomarker potential in prolonged deliveries - a narrative review.Annals of medicine and surgery (2012) · 2025Article
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- Assessment of novel sonographic and biochemical tools for spontaneous preterm birth prediction in asymptomatic twin pregnancies.Acta obstetricia et gynecologica Scandinavica · 2025Article
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- Equilibrium mechanical properties of the human uterus in tension and compression.Acta biomaterialia · 2025Article
- Predictors of Inflammation-Mediated Preterm Birth.Physiology (Bethesda, Md.) · 2025Review
- Piezo1 overexpression in the uterus contributes to myometrium contraction and inflammation-associated preterm birth.Journal of translational medicine · 2024Article
- Prediction of preterm birth using machine learning: a comprehensive analysis based on large-scale preschool children survey data in Shenzhen of China.BMC pregnancy and childbirth · 2024Article
- Development and validation of a nomogram for individualized prediction of spontaneous extremely preterm birth at < 28 weeks in twin pregnancy: a retrospective cohort study.Archives of gynecology and obstetrics · 2024Article
- Identification and characterization of plasma proteins associated with intra-amniotic inflammation and/or infection in women with preterm labor.Scientific reports · 2024Article
- Oxytocin augmentation and neurotransmitters in prolonged delivery: An experimental appraisal.European journal of obstetrics & gynecology and reproductive biology: X · 2024Article
- Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor.Bioengineering (Basel, Switzerland) · 2024Review
33 more citing papers are in PubMed but not listed here.
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Authors and funding
20 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveUterine overdistention is thought to induce preterm labor in women with twin and multiple pregnancies, but the pathophysiology remains unclear. We investigated for the first time the pathogenesis of preterm birth associated with rapid uterine distention in a pregnant nonhuman primate model. STUDY
designA nonhuman primate model of uterine overdistention was created using preterm chronically catheterized pregnant pigtail macaques (Macaca nemestrina) by inflation of intraamniotic balloons (N = 6), which were compared to saline controls (N = 5). Cesarean delivery was performed due to preterm labor or at experimental end. Microarray, quantitative reverse transcriptase polymerase chain reaction, Luminex (Austin, TX), and enzyme-linked immunosorbent assay were used to measure messenger RNA (mRNA) and/or protein levels from monkey (amniotic fluid, myometrium, maternal plasma) and human (amniocytes, amnion, myometrium) tissues. Statistical analysis employed analysis of covariance and Wilcoxon rank sum. Biomechanical forces were calculated using the law of Laplace.
resultsPreterm labor occurred in 3 of 6 animals after balloon inflation and correlated with greater balloon volume and uterine wall stress. Significant elevations of inflammatory cytokines and prostaglandins occurred following uterine overdistention in an "inflammatory pulse" that correlated with preterm labor (interleukin [IL]-1β, tumor necrosis factor [TNF]-α, IL-6, IL-8, CCL2, prostaglandin E2, prostaglandin F2α, all P < .05). A similar inflammatory response was observed in amniocytes in vitro following mechanical stretch (IL1β, IL6, and IL8 mRNA multiple time points, P < .05), in amnion of women with polyhydramnios (IL6 and TNF mRNA, P < .05) and in amnion (TNF-α) and myometrium of women with twins in early labor (IL6, IL8, CCL2, all P < .05). Genes differentially expressed in the nonhuman primate after balloon inflation and in women with polyhydramnios and twins are involved in tissue remodeling and muscle growth.
conclusionUterine overdistention by inflation of an intraamniotic balloon is associated with an inflammatory pulse that precedes and correlates with preterm labor. Our results indicate that inflammation is an early event after a mechanical stress on the uterus and leads to preterm labor when the stress is sufficiently great. Further, we find evidence of uterine tissue remodeling and muscle growth as a common, perhaps compensatory, response to uterine distension.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.