LAUSR

ajor advances in obstetrics and neonatology over the risk high-reward arena for therapeutics development by the M last few decades have led to significant improvements in the mortality and morbidity associated with preterm births. However, with >15 million preterm deliveries worldwide, preterm birth remains one of the leading causes of neonatal mortality resulting in w1 million deaths annually. Among survivors, there is a high incidence of neurological impairment including cerebral palsy, deafness, blindness, cognitive disabilities, and behavioral dysfunction including autism spectrum disorders. Morbidity among survivors is reported to be as high as 91% of neonates born at 24 weeks of gestational age and remains high at 56% even at 27 weeks of gestation. Therapeutic strategies to prevent and treat preterm labor have ranged from suppression of uterine contractions using systemically administered tocolytics to treatment of maternal infection/inflammation and use of vaginal progesterone in atrisk patients. Although advances in prenatal care and identification and treatment of at-risk patients have decreased morbidities from preterm births over the last decade, therapies to stop preterm labor once uterine contractions have started have not proven to be effective. Unfortunately, the drugs currently used for tocolysis have systemic side effects that affect the mother and/or the fetus. Drugs such as b2 adrenergic receptor agonists and calcium channel blockers have maternal cardiovascular side effects, while prostaglandin inhibitors such as indomethacin have fetal effects (closure of ductus arteriosus) and magnesium has been associated with increased fetal/neonatal mortality. Therefore, there is an urgency to develop strategies to address preterm labor in a specific and targeted manner. Novel developments in nanotechnology have been slow to be adapted to perinatal health since it is often viewed as a high-