FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 356:271-283 January 18, 2007 Number 3 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text PowerPoint Slide Set Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

The mechanisms that instigate parturition in humans have been remarkably elusive, but some parts of the puzzle have begun to come together. A key change in the field was the realization that human parturition is a distinctly human event — animal models can reveal only limited insights. Consequently, investigators of human parturition have come to understand that they must focus on the pregnant woman, despite the ethical difficulties in conducting studies that involve women in labor.

Preterm birth occurs in 5 to 15% of pregnancies, depending on the population.¹ The rates are rising in many developed countries, and there is . . . [Full Text of this Article]

The Uniqueness of Human Parturition

Corticotropin-Releasing Hormone and the Timing of Birth

Maternal CRH

CRH Receptors

CRH in the Fetus

Activation of the Myometrium at Term

Proteins That Promote Myocyte Contractility

Proteins That Increase Myocyte Excitability

Proteins That Promote Intercellular Connectivity

The Pathway to Myometrial Activation

Fetal Contributions to Parturition

Fetal Membrane Activation

Cervical Softening

Progesterone Withdrawal

Inflammation and the Onset of Labor

Source Information

From the Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, Australia.

Address reprint requests to Dr. Smith at the Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Lookout Road, Newcastle NSW 2310, Australia, or at roger.smith@newcastle.edu.au.

This article has been cited by other articles:

• Tyson, E. K., Smith, R., Read, M. (2009). Evidence that Corticotropin-Releasing Hormone Modulates Myometrial Contractility during Human Pregnancy. Endocrinology 150: 5617-5625 [Abstract] [Full Text]  
• Boyd, H. A., Poulsen, G., Wohlfahrt, J., Murray, J. C., Feenstra, B., Melbye, M. (2009). Maternal Contributions to Preterm Delivery. Am J Epidemiol 170: 1358-1364 [Abstract] [Full Text]  
• Stephansson, O., Kieler, H., Granath, F., Falconer, H. (2009). Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome. Hum Reprod 24: 2341-2347 [Abstract] [Full Text]  
• Tong, D., Lu, X., Wang, H.-X., Plante, I., Lui, E., Laird, D. W., Bai, D., Kidder, G. M. (2009). A Dominant Loss-of-Function GJA1 (Cx43) Mutant Impairs Parturition in the Mouse. Biol. Reprod. 80: 1099-1106 [Abstract] [Full Text]  
• Sharkey, J. T., Puttaramu, R., Word, R. A., Olcese, J. (2009). Melatonin Synergizes with Oxytocin to Enhance Contractility of Human Myometrial Smooth Muscle Cells. J. Clin. Endocrinol. Metab. 94: 421-427 [Abstract] [Full Text]  
• Carvajal, J. A., Delpiano, A. M., Cuello, M. A., Poblete, J. A., Casanello, P. C., Sobrevia, L. A., Weiner, C. P. (2009). Brain Natriuretic Peptide (BNP) Produced by the Human Chorioamnion May Mediate Pregnancy Myometrial Quiescence. Reproductive Sciences 16: 32-42 [Abstract]  
• Gellersen, B., Fernandes, M.S., Brosens, J.J. (2009). Non-genomic progesterone actions in female reproduction. Hum Reprod Update 15: 119-138 [Abstract] [Full Text]  
• Samalecos, A., Gellersen, B. (2008). Systematic Expression Analysis and Antibody Screening Do Not Support the Existence of Naturally Occurring Progesterone Receptor (PR)-C, PR-M, or Other Truncated PR Isoforms. Endocrinology 149: 5872-5887 [Abstract] [Full Text]  
• Zhang, J., Sundaram, R., Sun, W., Troendle, J. (2008). Fetal Growth and Timing of Parturition in Humans. Am J Epidemiol 168: 946-951 [Abstract] [Full Text]  
• Menon, R., Arora, C. P., Hobel, C. J., Fortunato, S. J. (2008). Corticotrophin-Releasing Hormone in Lipopolysaccharide-Stimulated Term Fetal Membranes and Amniotic Fluid From Term and Preterm Birth in African Americans and Caucasians. Reproductive Sciences 15: 477-483 [Abstract]  
• Lirussi, F., Rakotoniaina, Z., Madani, S., Goirand, F., Breuiller-Fouche, M., Leroy, M.-J., Sagot, P., Morrison, J. J., Dumas, M., Bardou, M. (2008). ADRB3 Adrenergic Receptor Is a Key Regulator of Human Myometrial Apoptosis and Inflammation During Chorioamnionitis. Biol. Reprod. 78: 497-505 [Abstract] [Full Text]  
• Yue Hou, , Xiaolu Tang, , Nicholson, R. C., Xin Ni, (2008). Phorbol Ester Stimulates Corticotropin-Releasing Hormone Gene Promoter Activity Through a cAMP Regulatory Element in Primary Placental Cells. Reproductive Sciences 15: 33-39 [Abstract]  
• MacIntyre, D. A., Tyson, E. K., Read, M., Smith, R., Yeo, G., Kwek, K., Chan, E.-C. (2008). Contraction in Human Myometrium Is Associated with Changes in Small Heat Shock Proteins. Endocrinology 149: 245-252 [Abstract] [Full Text]  
• Florio, P., Linton, E. A., Torricelli, M., Faldini, E., Reis, F. M., Imperatore, A., Calonaci, G., Picciolini, E., Petraglia, F. (2007). Prediction of Preterm Delivery Based on Maternal Plasma Urocortin. J. Clin. Endocrinol. Metab. 92: 4734-4737 [Abstract] [Full Text]  
• Brinkman-Van der Linden, E. C M, Hurtado-Ziola, N., Hayakawa, T., Wiggleton, L., Benirschke, K., Varki, A., Varki, N. (2007). Human-specific expression of Siglec-6 in the placenta. Glycobiology 17: 922-931 [Abstract] [Full Text]  
• O'Brien, M., O'Shaughnessy, D., Ahamide, E., Morrison, J. J., Smith, T. J. (2007). Differential expression of the metalloproteinase MMP3 and the {alpha}5 integrin subunit in human myometrium at labour. Mol Hum Reprod 13: 655-661 [Abstract] [Full Text]  
• Simhan, H. N., Caritis, S. N. (2007). Prevention of Preterm Delivery. NEJM 357: 477-487 [Full Text]  
• O'Sullivan, J., Iyer, S., Taylor, N., Cheetham, T. (2007). Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is associated with a prolonged gestational age. Arch. Dis. Child. 92: 690-692 [Abstract] [Full Text]