Chorioamnionitis as a key cause of extremely preterm births (a review of global data)

Preterm labor remains a leading cause of neonatal morbidity and mortality worldwide. Investigating the etiopathogenetic factors contributing to preterm birth and developing preventive interventions are key objectives in obstetric research. Aim - to examine and integrate existing evidence on the impact of chorioamnionitis, including its subclinical forms, on preterm labor; to analyze potential interventions and evidence-based approaches for modern treatment; and to identify promising strategies in this field. A review of contemporary evidence-based medical literature was conducted. Primary searches were carried out in four separate databases. Numerous independent studies have documented correlations between infectious factors and preterm birth. The most reliable findings have been provided by pathologists, who described histological evidence of intrauterine infection in 75% of preterm births, with a declining trend as gestational age increase. Epidemiological research using laboratory and clinical data reveals a correlation between preterm birth and the presence of asymptomatic bacteriuria, as well as alterations in the vaginal microbiome. In patients with cervical shortening - a marker of preterm labor - and subclinical intrauterine infection, antibiotic therapy has been shown to resolve the infectious process, reverse symptoms, and prolong pregnancy in 75% of cases. Conclusions. The analysis confirmed a clear association between chorioamnionitis (both clinical and subclinical, histologically confirmed) and the development of preterm labor. The proportion of chorioamnionitis increases as gestational age decreases. Diagnostic amniocentesis is the method of choice for confirming the diagnosis of chorioamnionitis, particularly in subclinical cases, which can significantly alter treatment approaches and improve pregnancy outcomes. The authors declare no conflict of interest.