Journal of Pregnancy and Child Health
Open Access

Preterm birth, defined as the delivery of a baby before 37 weeks of gestation, continues to be a leading cause of neonatal morbidity and mortality worldwide. Despite advancements in prenatal care, the precise molecular mechanisms responsible for the initiation of preterm labor remain incompletely understood. Recent research has shifted focus toward the placenta, an organ traditionally viewed primarily as an interface for nutrient and gas exchange between the mother and fetus. However, emerging evidence highlights the placenta’s role in regulating various biological processes that, when disrupted, may trigger preterm labor. One of the most significant advances in this area is the discovery that the placental transcriptome the complete set of RNA molecules expressed in the placenta plays a pivotal role in the pathophysiology of preterm birth. This review investigates how alterations in the placental transcriptome may contribute to preterm birth and explores the potential for placental RNA as a diagnostic biomarker [1].

Placental Function and Transcriptome Regulation

The placenta is an essential organ that supports fetal development by providing nutrients, oxygen, and waste removal, while also mediating immune tolerance between the mother and fetus. It produces numerous hormones necessary for pregnancy maintenance, such as human chorionic gonadotropin (hCG), progesterone, and estrogen. The placental transcriptome reflects the dynamic changes that occur within the placenta as it adapts to the changing needs of the developing fetus. The placental transcriptome is shaped by various factors, including maternal physiology, fetal growth requirements, and environmental exposures. It is the intricate balance between these factors that ensures proper placental function and, by extension, a healthy pregnancy. However, dysregulation in the placental transcriptome can lead to functional abnormalities in the placenta, which may trigger complications such as preterm birth [2].

Inflammatory Pathways in Preterm Birth

Inflammation has long been recognized as a key mechanism underlying preterm birth. The placenta plays a central role in the inflammatory response during pregnancy, and its transcriptome reflects changes in gene expression that regulate immune responses. In normal pregnancy, a controlled inflammatory environment is essential for fetal development and parturition. However, excessive inflammation is thought to play a central role in triggering preterm labor. Altered gene expression profiles in the placental transcriptome have been identified in women who experience preterm birth, with an upregulation of pro-inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These inflammatory mediators can induce uterine contractions, cervical dilation, and rupture of the membranes, all of which are key events in the initiation of labor. The placenta's inflammatory response, regulated by its transcriptome, is thus a critical factor in the pathophysiology of preterm birth. Several studies have provided evidence that preterm birth is associated with changes in the placental expression of inflammatory genes. A heightened inflammatory response within the placenta can trigger premature labor by altering the local uterine environment. These findings suggest that placental inflammation may act as an early signal for preterm birth. Moreover, the identification of specific inflammatory gene signatures within the placental transcriptome could offer potential biomarkers for predicting the risk of preterm labor [3].

Trophoblast Dysfunction and Placental Development

Trophoblast cells, which form the outer layer of the placenta, are responsible for invading the uterine wall to establish placental blood flow and support fetal growth. Proper trophoblast invasion is crucial for ensuring adequate oxygenation and nutrient supply to the fetus. However, in pregnancies that result in preterm birth, trophoblast function is often impaired. The placental transcriptome regulates key processes such as trophoblast migration, adhesion, and invasion, all of which are essential for placental development and function. Dysregulation of these processes can lead to inadequate placental perfusion, fetal hypoxia, and ultimately, preterm labor. Studies have shown that altered gene expression in the placental transcriptome is associated with impaired trophoblast function in preterm births. For example, the expression of genes involved in trophoblast invasion and vascular remodeling is often downregulated in placentas from women who deliver prematurely. These changes suggest that insufficient placental development, driven by aberrant gene expression, may contribute to the initiation of preterm birth by causing placental insufficiency and fetal distress [4].

Oxidative Stress and Placental Dysfunction

Another important factor that may contribute to preterm birth is oxidative stress. The placenta is particularly susceptible to oxidative damage due to its high metabolic activity. Reactive oxygen species (ROS) produced by the placenta can lead to cellular damage and inflammatory responses, disrupting placental function. The placental transcriptome plays a crucial role in regulating the antioxidant defense mechanisms that protect the placenta from oxidative stress. In pregnancies complicated by preterm birth, studies have shown changes in the expression of genes involved in the oxidative stress response. Genes such as superoxide dismutase (SOD) and catalase, which protect cells from oxidative damage, are often upregulated in the placentas of women who experience preterm birth. These alterations in the placental transcriptome suggest an imbalance between oxidative stress and antioxidant defense mechanisms, which could compromise placental function and contribute to the premature onset of labor [5].

Placental RNA as a Diagnostic Biomarker for Preterm Birth

Given the central role of the placenta in preterm birth, there is growing interest in using placental RNA as a biomarker for early detection. The placenta sheds RNA molecules into the maternal bloodstream, providing a non-invasive method for monitoring placental function. High-throughput RNA sequencing technologies have enabled comprehensive profiling of the placental transcriptome, revealing a wealth of potential biomarkers for preterm birth. Specific gene expression patterns linked to inflammation, oxidative stress, and trophoblast dysfunction could be used to predict preterm labor. By identifying these biomarkers, clinicians could potentially intervene earlier in pregnancies at risk for preterm birth, implementing preventive measures such as corticosteroid therapy or cervical cerclage to reduce the likelihood of early delivery [6].

Conclusion

The placental transcriptome plays a crucial role in the pathophysiology of preterm birth by regulating a variety of biological processes, including inflammation, trophoblast function, and oxidative stress response. Dysregulation in the placental gene expression associated with these processes can lead to placental dysfunction and the premature initiation of labor. The ability to profile the placental transcriptome offers an exciting opportunity to identify biomarkers for early prediction and diagnosis of preterm birth. As research in this field progresses, it is likely that placental RNA will emerge as a key tool for improving maternal and neonatal health by enabling earlier and more targeted interventions in pregnancies at risk for preterm delivery.

1. Stuge B (2019) Evidence of stabilizing exercises for low back- and pelvic girdle pain, a critical review. Braz J Phys Ther 23: 181-186.

Indexed at, Google Scholar, Crossref

2. Gilleard WJ, Crosbie, Smith R (2002) Effect of pregnancy on trunk range of motion when sitting and standing. Acta Obstetricia Gynecologica Scandinavica 81: 1011-1020.

Indexed at, Google Scholar, Crossref

3. Butler EE (2006) Postural equilibrium during pregnancy: Decreased stability with an increased reliance on visual cues. Am J Obstet Gynecol 195: 1104-1108.

Indexed at, Google Scholar, Crossref

4. Agbevade Akpeko (2018) Value chain and local economic development in the shai-Osudoku district assembly of Ghana: The experience of the Asutuare rice farming project 10: 7-19.

Google Scholar, Crossref

5. Evans Sackey Teye, Philip Tetteh Quarshie (2021) Impact of agricultural finance on technology adoption, agricultural productivity and rural household economic wellbeing in Ghana: a case study of rice farmers in Shai-Osudoku District 104: 231-250.

 Google Scholar, Crossref

6. RichardK D Ephraim, Prince Adoba, SamuelA Sakyi, Josephine Aporeigah (2020) Acute kidney injury in pediatric patients with malaria: A prospective cross-sectional study in the shai-osudoku district of Ghana 31: 235.

Indexed at, Google Scholar, Crossref