MECHANISMS OF FETOPLACENTAL ADAPTATION IN CASES OF PRETERM DELIVERY

Preterm birth, defined as delivery before 37 weeks of gestation, remains a major contributor to neonatal morbidity and mortality, as well as long-term health complications among surviving infants. Children born prematurely are at higher risk of developing respiratory and gastrointestinal disorders, neurological impairments, and delays in both physical growth and cognitive development. Nevertheless, timely medical intervention and appropriate neonatal care can considerably improve outcomes in this vulnerable group.The compensatory and adaptive responses of the fetoplacental system in preterm birth represent a set of structural and functional adjustments aimed at sustaining fetal viability when pregnancy ends earlier than expected. These processes involve modifications in placental morphology and function, as well as alterations in fetal metabolic activity. Placental dysfunction, often referred to as placental insufficiency, is closely linked with several obstetric complications, including pre-eclampsia and intrauterine growth restriction, both of which increase the likelihood of preterm labor—a leading global cause of perinatal morbidity and mortality. Although the term “placental insufficiency” is widely used in clinical practice, the lack of a standardized definition and universally accepted diagnostic criteria complicates its interpretation and clinical application.