Stress-associated preterm delivery: The role of corticotropin-releasing hormone

Objective: The study’s objective was to provide an introduction to the role of corticotropin-releasing hormone in preterm delivery associated with stress. Study Design: A selective review of the current literature relevant to the objective was undertaken. Published data were analyzed for relevance to the biochemical model presented. Results: Preterm delivery is a leading cause of neonatal morbidity and mortality. Efforts to prevent preterm delivery have been greatly hampered by a poor understanding of the underlying pathophysiology. There is increasing clinical and laboratory evidence that many preterm deliveries result from maternal and fetal stress, which activates cells in the placenta, decidua, and fetal membranes to produce corticotropin-releasing hormone. Corticotropin-releasing hormone in turn enhances prostaglandin production in these tissues to promote parturition. Conclusion: Corticotropin-releasing hormone plays an important role in the etiology of preterm delivery associated with maternal or fetal stress. (Am J Obstet Gynecol 1999;180:S264-6.)