Alphabetical list of Abstracts by first name
Regulatory Role of miRNA in Epigenetic Modification of Taupathies
Amla Chopra and Bhavna Pydah
Department of Zoology, Dayalbagh Educational Institute, Dayalbagh, Agra 282005
Alzheimer‘s disease (AD) is one of the most common forms of dementia in the world and being one of the most devastating neurodegenerative diseases, eventually leading to the death of the patient. To this date there is still no cure for this disease. Our study focused on the epigenetic writing and erasing of the Tau gene. We thus selected HDAC6 (Histone
deacetylase 6), HDAC2 (Histonedeacetlyase 2), CDK5 (Cyclin dependent kinase 5), GSK3β genes for the development of better epigenetic understanding based therapeutic targets. microRNA-gene (HDAC6, HDAC2, CDK5 or GSK3β) interaction demonstrated the involvement of specific miRNA regulation the target genes.
During AD pathogenesis, TAU, a microtubule binding protein is hyper-phosphorylated at
multiple sites. Hyper-phosphorylated TAU protein eventually aggregates into intracellular
neurofibrillary tangles (NFTs) that are—next to amyloid plaques—a key hallmark of AD.
The role of HDACs in the adult brain has gained much attention since they have emerged as promising drug targets for brain diseases. However, their exact mechanism of regulation is yet to be understood.
The selected genes HDAC6 (Histone deacetylase 6), HDAC2 (Histonedeacetlyase 2), CDK5 (Cyclin dependent kinase 5), GSK3β (Glycogen Synthase Kinase 3 β) were subjected to in silico bioinformatics tools to study microRNA-gene interaction. After prediction, filtration of the interacting miRNAs with selected genes and validation the final selected miRNA binding to the target genes 4 miRNAs –hsa-miR-939, hsa-miR- 1207-5p, hsa-miR-22, hsa-miR222-3p target HDAC6. 9 miRNAs- hsa-miR-490-5p, hsa-miR-526b, hsa-miR-325, hsa-miR619, hsa-miR-632, hsa-miR-612, hsa-miR-634, hsa-miR-331-3p, hsa-miR502-5p have shown to interact with HDAC2. 6 miRNA- hsa-miR-222, hsa-miR-625, hsa-miR-1207-5p, has miR-632, hsa-miR-325, hsa-miR-612 target GSK3B gene. 2 miRNAs- hsa-miR-610 and has miR-612 target CDK5 gene. These miRNAs were then subjected to pathway analysis to deduce whether they could interact with our selected genes as well as other genes involved in neural pathways. It was found that these miRNAs are important in many neural pathways, such as axon guidance pathway, glutamate receptor synthesis pathway, showing that the predicted miRNA could bind to the target genes and regulate them. The direct evidence of effect of meditation on the expression of HDAC2 also indicates the possible therapeutic role of meditation in diseases such as Alzheimer’s Disease.
Because of climate change we are no longer alone in the world! How to tackle this issue in different sectors, countries and international negotiation?
The particular importance of land use and biomass
Co-Noblauriet, IPCC 2007 Former Director Research INRA, France
Complying with the Paris agreement is a huge and complicated challenge for governments, enterprises of different sectors (including in agriculture), as well as for individual citizens and international negotiators. Net GHG emissions are to be curbed drastically at the world level and to come close to zero by 2050. This requires in most sectors immense and unprecedented changes, completely opposite to what happened and has been promoted by every government since the industrial revolution. Land use (including forestry), is an exception: first because due to the photosynthetic activity of plants which is neguentropic; and because of the word population growth and the need to replace fossil fuel by biomass, food and non food biomass production is still to be further increased and optimized everywhere in the world. The singularity of photosynthetic activities is usually and unfortunately not yet properly understood by most people, even at academic levels. This will be underlined in the presentation as it needs to be changed.
Past approaches under the Kyoto Protocol are no longer valid and renewed accounting systems as well adequate frameworks are to be introduced. Dealing properly with this issue requires a comprehensive understanding, in each sector at local, national and international level, not only by some specialists but of the whole society, in each and every country. Possibilities to obtain the required changes need is also elaborating adequate, socially applicable and acceptable policies and measures. Revisiting some simplistic approaches, even at academic levels, is therefore necessary.
There is also a need to remove obstacles and change approaches which prevent these changes to take place. Each and every one of course prefers other - persons, sectors or countries- acting first. Some false approaches promoted by group of interests, and/or by ignorance in some countries are to be identified and therefore to be highlighted. Institutional approaches preventing to properly hierarchies actions are also to be modified. And last but not least increased solidarity and fraternity between people in each country, and between countries at the global level, is also necessary if we want really these changes to take place. This requires also reframing geopolitical approaches in each country.
Addressing climate change and child malnutrition know-do gaps through academic-community partnerships and community-based research
Ashley Aimone Ph.D.
Hospital for Sick Children and Dalla Lana School of Public Health,
University of Toronto, CANADA
School of Public Health, Moi University, KENYA
Child malnutrition continues to be highly prevalent in many low- and middle-income countries (LMICs), particularly in Sub-Saharan Africa. Food insecurity plays a central role in malnutrition and exposure to more complex, frequent and intense climate variability and extremes has been found to be a key driver behind all dimensions of food insecurity (availability, access, utilization and stability); especially in LMICs where the agriculture sector makes up a large component of the economic and social livelihoods of a population. Similarly, nutrition is highly climate-sensitive, and evidence from population-level analyses suggest that children in rural agricultural regions of Sub-Saharan Africa may be among those at highest risk of food insecurity and malnutrition in the context of CEC. Reducing the burden and inequities of malnutrition under the pressures of climate change is a prioritized global public health target, and meeting this target will require accelerated and scaled up action to strengthen the resilience and adaptive capacity of food systems. While high-level ecological analyses play an important role in improving our understanding of climate, food, and health interactions; there is a persistent and unbalanced gap between the amount of this knowledge and its implementation. What is lacking is research at the community level that focuses on developing strategies to integrate empirical evidence with indigenous knowledge, and uses practical and participatory approaches to share research findings with relevant knowledge users. Our research seeks to address this knowledge-to-action gap by building and strengthening local university-community partnerships, and using a community-based participatory research approach to bring together the ‘right knowledge’ and the ‘right people’ and instigate collective action towards improved climate resilience, food security, and child nutrition among smallholder farming communities in East Africa.
Evaluation of an innovative botanical drug, SKB108 for Multiple Sclerosis
Ashok Kumar, Ph.D. and Priti Kumar, Ph.D.
Centre for Research in Integrative Medicine
SK Bio therapeutics Pvt. Ltd, Aligarh, U.P.
Millions of people around the world are suffering from various types of chronic diseases which are of longer duration and slow progression causing deterioration of tissues and organs resulting in accelerated aging and death. It is estimated that one out of every two adults suffers with at least one chronic degenerative illness. Most of these diseases are incurable and are being just managed at the best with presently available allopathic and AYUSH therapies. Unavailability of curative therapies for these disorders is a matter of great concern.
Single molecule drugs have played significant role in managing the symptoms of chronic diseases. However, issues of unavailability of curative therapeutics, suboptimal response, treatment resistance and adverse drug reactions remain problematic and pose a serious concern. Multi-component botanical drugs validated for their safety and efficacy offer an opportunity to successfully reduce the burden of chronic diseases in cost effective manner. We have developed one such botanical drug, SKB108 for curative treatment of chronic inflammatory diseases as evidenced in single arm historically controlled clinical trials.
Multiple Sclerosis (MS) is a chronic disabling disease of the brain and spinal cord in which immune system attacks the protective myelin sheath causing communication problems between brain and rest of the body. Experimental Autoimmune Encephelomyelitis (EAE) in mice is used for studying MS. We have evaluated this botanical drug, SKB108 for its effectiveness to check development of EAE in mice, thus paving path for further studies for prevention and treatment of MS.
Prenatal stress and the developing brain: risks for neurodevelopmental disorders
Bea R.H. Van den Bergh
Department of Welfare, Public Health and Family, Flemish Government, Brussels, Belgium
Health Psychology, University of Leuven – KU Leuven, Leuven, Belgium
Accumulating research shows that prenatal exposure to maternal psychological distress increases the risk for behavioural and mental health problems later in life. Effects of maternal stress on offspring neurodevelopment, cognitive development, negative affectivity, difficult temperament and psychiatric disorders are shown in numerous epidemiological and case-control studies. Offspring of both sexes are susceptible to prenatal stress but effects differ. There is not any specific vulnerable period of gestation; prenatal stress effects vary for different gestational ages possibly depending on the developmental stage of specific brain areas and circuits, stress system and immune system. The prenatal period is increasingly considered as a crucial target for the primary prevention of neurodevelopmental and psychiatric disorders. Understanding their pathophysiological mechanisms remains a great challenge. This presentation focuses on results of studies examining the effect of prenatal exposure to maternal distress on offspring brain development. Paradigms used in (infant) research using brain imaging techniques such as electroencephalography and (functional) magnetic resonance imaging ((f)mri) are shown. The studies reveal effects in the offspring at birth and up into adulthood. Structural and functional brain changes are observed in several brain regions including prefrontal, parietal and temporal lobes, cerebellum, hippocampus and amygdala. Furthermore, alterations are seen in functional connectivity of amygdalar-thalamus networks and in intrinsic brain networks, including default mode and attentional networks. However, more prospective long-term longitudinal follow-up studies starting early in pregnancy should be carried out, in order to examine how brain imaging measures may mediate the link between prenatal stress and offspring behavioural, cognitive, emotional problems and susceptibility for disorders.
Prenatal maternal stress, preterm birth and adverse outcomes: risk identiﬁcation and interventions
David M. Olson, Ph.D., FRCOG, FCAHS
Department of Obstetrics and Gynaecology, University of Alberta Edmonton, Canada
Among the most devastating and insidious problems in health are the effects of chronic stressors on the pregnant woman and her foetus, new born and child. In our contemporary world a number of environmental factors due largely to man-made problems including climate change leading to natural disasters, megacities, migration, abuse and the metabolic syndrome (e.g. overweight/obesity, Type 2 diabetes and cardiovascular disease) affect the health of women during pregnancy and that of their children and generations beyond. Potential inﬂammatory mechanisms triggered by these processes will be described. The accumulation of stresses will be framed within the concept of increasing allostatic load. Advances in developing simple and innovative predictors of risk will be shared and the effect of novel interventions to mitigate these risks will be described. Overall, the relationship of these problems, predictors and interventions to the OPERA program approach to improving pregnancy and new born health will be emphasized.
Climate change and challenges for the plant breeding from an animal nutrition perspective
Gerhard Flachowsky, Ulrich Meyer (Braunschweig, Germany) and Rishi Behl (Hisar, India)
The plant breeding is the starting point for the whole food and feed chain and partly for bioenergy production. Feed stuffs arising during the processing of bioenergy crops in the future. Traditional breeding and green biotechnology are the prerequisites for high and stabile yields of plants, resistance against biotic and abiotic stressors and a low content of undesirable substance in food and feed.
The global climate change is characterized by many changes in environmental conditions, such as:
Increase in average temperature and higher risks for drought (deficiency in water)
Higher risks for extreme weather situations
Increase of saltwater level in the oceans and probably salinisation of the soil in arid areas - Increase of CO2-level in the air (from about 380 upto 600 ppm).
Plant breeders know this situation and consider such climate changes in their long-term breeding programmes, with the aims of achieving:
More efficient use of water, improve of water using efficiency
More drought resistance
Higher tolerance against cold, heat, flooding and salt
More efficient intake and use of nutrients (e.g. N and CO2 from the air)
Higher resistance against microorganisms and insects
Higher temperatures may decrease the yields of some plants, but more CO2as plant nutrient may increase the yields of some plants, but may decrease the content of protein, aminoacids and some minerals in grains.
More fundamental research of public research institutions seems to be necessary to solve such fundamental problems as mentioned above.
More detail here described by Flachowsky and Meyer (2015; Challenges for plant breeders from the view of animal nutrition; Agriculture 15, 5, 1252-1276)
Our Ancestors’ Ghosts: Transgenerational Trauma as a Determinant of Disease Risk and Stress Resilience
Gerlinde A.S. Metz, Ph.D.
Canadian Centre for Behavioural Neuroscience
Department of Neuroscience, Faculty of Arts & Science University of Lethbridge, Lethbridge, Alberta, CANADA
Adverse early life experiences influence developmental trajectories and often have life-long consequences. For example, prenatal or early postnatal exposure to stress may enhance stress sensitivity and increase the risk of disease later in life. Recent research has shown that the experience of stress and trauma may also influence the health of future generations. Using experimental rodent models, work in our laboratory has shown that consequences of early life stress can propagate across four generations of offspring and increase their risk of preterm birth, psycho pathologies and complex diseases. The adverse health outcomes are associated with characteristic behavioural, endocrine and metabolic markers and epigenetic signatures. The formation of an epigenetic memory that propagates from one generation to the next may be the central mechanism in trans generational programming of disease risk. In turn, adverse trans generational programming by stress can be reversed by positive experiences and life style changes. The insight that resilience to ancestral stress and trauma can be fostered by enrichment and experiential interventions has particular importance for clinical studies. Current efforts are directed towards the identification of biochemical pathways that link stressful experiences to disease risk and to use biological signatures of stress to predict adverse health outcomes at an early age. The finding that epigenetic modifications via microRNAs could be a primary mechanism of stress transfer and reversal by interventions bears implications for the discovery of new therapeutic targets or predictive biomarkers of disease in precision medicine approaches. Strategies that support healthy development and successful ageing should take into account the potential influences of trans generational inheritance. (Funded by AI-HS, CIHR and NSERC).
Father’s legacy: How paternal exposure to environmental contaminants can harm future generations
Janice L. Bailey Ph.D.
Centre for Reproduction, Development & Intergenerational Health
Animal Science Department, Faculty of Agricultural & Food Sciences
Université Laval, Quebec City, CANADA
It is well established that the maternal environment can affect the subsequent health of her children. Early development is sensitive to toxicants and maternal consumption of contaminated food during pregnancy and is associated with negative outcomes. There is an increasing body of evidence, however, demonstrating that adverse effects of environmental exposures can also be transmitted to offspring via their fathers. Therefore, our team is concerned about paternal exposure to chemical contaminants and their effects on future generations. Persistent Organic Pollutants (POPs) are contaminants of global concern due to their potential for long-range transport, ability to biomagnify and bio-accumulate in ecosystems, and their negative effects on human health and the environment. Common POPs include industrial chemicals, most notably polychlorinated biphenyls (PCB), organochloride pesticides, such as DDT, and dioxins, which are industrial by-products.
Although their production has been greatly restricted following the application of the Stockholm Convention in 2004, POPs contamination remains ubiquitous worldwide. Our overarching hypothesis is that paternal exposure to an environmentally relevant mixture of POPs induces developmental complications in his offspring and subsequent generations.A multigenerational study using our Sprague Dawley rat model confirms that early-life paternal exposure to these contaminants perturbs his fertility parameters and the development of his descendants across several, unexposed generations. A possible mechanism for transmitting paternal exposures is via his sperm epigenome. Indeed, both the sperm DNA methylome and non-coding RNAs are altered across multiple generations of sons. These results suggest that the legacy of POPs will endure; therefore, therapeutic strategies to reduce their impact will be discussed. (Funded by FRQNT, CIHR & NSERC.)
Mushrooms: Production, nutritive value and improvement
Ex-Director, ICAR- Directorate of Mushroom Research, Solan
Mushrooms have been collected and consumed since times immemorial. Cultivation of mushrooms like Auricularia, Flammulina, Lentinula were attempted hundred years ago in China. Button mushroom cultivation started in caves in France in 1650. Scientific cultivation, however, started only at the beginning of the 20th century when pure cultures of mushroom were prepared from spore and tissue. Mushrooms are a quality food and their demand is on increase. Cultivation in the beginning of the 20th century was focused on button mushroom and was slow. The production was mainly in USA and Europe. In first half of the 20th century the focus was on cultivation of button mushroom in West and to a lesser extent on Shiitake in East. In second half of 20th century there were rapid changes in rate of growth of mushroom production and number of species under commercial cultivation. 21st Century, particularly last ten years, have witnessed sudden rapid rise in cultivation of mushrooms other than button. Net result is an exponential growth in world mushroom production. Due to almost unimaginable growth in production of shiitake, oyster mushrooms, wood ear mushroom and Flamullina, the contribution of these mushrooms to total world mushroom production has increased tremendously as compared to button mushroom which is no more the number one mushroom in terms of share in global mushroom production. In the last four decades, the global mushroom production has increased more than 20 times. Six mushroom species (Agaricus, Pleurotus, Lentinula, Flammulina, Auricularia and Volveriella species) contribute towards 90 percent of global mushroom production. Major contributor in mushroom production is China where button is considered an exotic mushroom. Within each country there are specific regions contributing to mushroom production. There have been technological changes in last century. For example spawn production started only in the beginning of 20th century and we have seen changes from Milk bottles to glucose bottles to polypropylene bags to liquid spawn. There have been changes from non-absorbent cotton plugs to poly-fill to filter bags. Similarly composting methods for button mushroom have changed from long method compositing to short method having Phase I and II to phase III. The white button mushroom, so popular today, was selected from brown buttons in 1926 in USA. Hybrid production started very late and it was in 1981 that first hybrid U1 was released. We started working on genetic improvement in 1984 and have developed seven varieties till date that include non browning hybrids like NBS 1 & 5. In wood fungi like oyster, shiitake there have been changes from log cultivation to bag cultivation to total automation for bottle cultivation. Large number of new species has been cultivated in 21st century. Changes in production technology and diversification have lead to exponential growth of mushroom production. Consumption in India is less than 100 g as compared to 6 kg as global average and more than 20 kg per person per year in China. We have achieved food security. The challenge now is to meet nutritional security. Mushrooms are a good vegetarian source of quality protein, vitamin D and Vitamin B12. These have no starch, low sodium, high fibre in addition to many novel compounds found only in Fungi. Mushrooms are a healthy food for diabetic, hypertension patients and have number of other medicinal benefits. There is need to promote their consumption.
What does recent evidence say for preterm management?
Dr. Neharika Malhotra Bora
Rainbow Hospital, Sikandra Agra
Preterm labor is defined as the onset of uterine contraction of adequate strength and frequency to cause progressive dilatation and effacement of cervix between 20 and 37 weeks of gestation. Preterm labor is one of the leading causes of prenatal morbidity and mortality. We must understand the primary and secondary prevention for preterm births.
TVS is the preferred modality for cervical length measurement and must be done for all cases at 13 weeks and 20 weeks for primary screening and prevention. Strict guidelines are now available for indications of circlage and must be followed for better outcomes.
Tocolysis may help to buy time but not prolong pregnancy for more than one week.
Administration of Magsulf should be incorporated in daily practice for neuroprotection.
Grain carbohydrates improvement for food and nutritional security
Ravindra N Chibbar
Department of Plant Sciences, University of Saskatchewan, 51 Campus Drive, Saskatoon, Saskatchewan, S7N 5A8, Canada
The last few decades seen new food habits and sedentary lifestyles, when combined has led to an overconsumption of calories (>11.3 MJ/day) and an increase in diet-related diseases, such as diabetes, coronary heart disease and colorectal cancer. To overcome the rising cost of healthcare in developed countries, reduction in the daily calorie intake is needed. On the other hand, people in developing countries need food that is completely digested to provide the maximum calories to meet the energy requirements for normal body functions. Therefore, grain quality is a dynamic concept which changes with the consumer. Cereal grains and pulses are the major food grains that satisfy the human dietary requirements. Carbohydrates are the predominant food component in these grains and the major source of energy (9.2 MJ/day) in human diet. Most of the carbohydrates are found in the large endosperm / cotyledons, where they occupy up to three-fourths of the space followed by proteins and lipids. The major carbohydrate starch is stored as an energy-dense and water-insoluble granule composed of one-quarter amylose and three-quarters amylopectin along with traces of lipids and proteins. Like most carbohydrates, starches of various botanical sources show structural diversity and small changes in their makeup can alter functional properties. For example, amylose deficient (waxy) and increased amylose wheat and barley grain starches show differences in the timing of energy release in form of calories when passed through the human digestive tract. Thus, starch is an important target for grain quality improvement to satisfy the demand for lower and higher energy foods for different market needs. Some of the targets for starch modification include alterations to starch granule size and amylopectin fine architecture which both influence starch digestibility. Other grain genetic improvement targets for human health include structural polysaccharides, such as dietary fibre, beta-glucan, and small sugars which can reduce calorie uptake and improve gastrointestinal health. Gene-based markers associated with grain size and composition can be used to develop genotypes with increased grain yield and quality. Some recent examples of our research with wheat, barley and chickpea will be presented.
Epigenetic variation in response to early life exposures: links to offspring health and disease in humans
Richard Saffery Ph.D.
Murdoch Children’s Research Institute and Department of Paediatrics,
University of Melbourne, AUSTRALIA
The Developmental Origins of Health and Disease (DOHaD) hypothesis predicts that environmental exposures in early life have the potential to modify the risk of later disease. This is supported by a large number of animal studies and a smaller number of studies in humans. However, the mechanism(s) underlying these ‘programming’ effects remain largely unclear. Mounting evidence implicates epigenetic (literally ‘above DNA’) in this process, however evidence in humans is limited, primarily due to the problems of untangling the contributions of genetic and environmental influence.
For more than a decade, our team have been developing longitudinal human cohorts, commencing prior to birth, with detailed exposure and outcome data, and extensive biospecimen collection to build evidence for role of epigenetic in this process. We have previously identified extensive variation in the human epigenetic profile across pregnancy, at birth and throughout childhood. We also found evidence that this is due to both underlying genetic profile and environmental exposures. More recently, we demonstrated that specific exposures in pregnancy (such as maternal stress, smoking or gestational diabetes) induce epigenetic variation in blood that may persist postnatal. Specific genes appear to show variation in epigenetic state in association with childhood growth and adiposity measures, while specific diseases (such as food allergy) are associated with distinct epigenetic and gene expression changes. Most recently, we have found compelling evidence those assisted-reproductive technologies (eg. IVF) induce epigenetic change at birth, some of which persists to adulthood.
In summary, mounting evidence suggests many different exposures can impact the human epigenetic profile and that this likely contributes to the rising incidence of a range of non-communicable diseases in humans, driven by gene-environment interactions.
Wheat Breeding Programs and Local Varieties in the Context of Global Climate Change
Ramazan AYRANCI1, Seydi Ahmet BAĞCI2
1 Department of Field Crops, Faculty of Agriculture, KırsehirAhi Evran University, Kırsehir,Turkey
2Department of Crop and Animal Production, Sarayönü Vocational School, Selcuk University, Konya, Turkey
Global climate change is one of the most important factors threatening world food security. Agriculture has a key role in the sustainability of life. The weakest aspect of agricultural production is that it is very clear to the effects of changes in climate factors. At the beginning of climate changes in the world and in our country, increasing air temperatures and drought attract attention. As in the world, in our country, a large part of the crop production is made in dry agricultural areas depending on the amount and seasonal distribution of precipitation. Cereals have a very important role to ensure the world food security. Wheat have the most cultivated area in cereals (219 million ha, IGC 2018) and is mostly grown in rain-fed areas. Global climate change and consequent environmental stress factors cause significant yield losses in wheat. Many measures are being taken to reduce the impacts of global climate change, such as the sustainable planning of agricultural water use and the development of cultivation techniques. One of these measures is to improve new varieties that are resistant to or tolerate environmental stress factors. Wheat breeding programs are carried out concerning resistance to environmental stress factors at national and international level in different countries. The most important factor in providing resistance to environmental stress to newly developed varieties in wheat breeding programs is the existence of appropriate gene source and genotypic variation that can adapt to changing climatic conditions. In this context, local varieties offer an important potential of gene resources in terms of providing resistance to marginal climatic conditions. In Turkey local varieties widely used in the breeding programs since 1960’s.Gerek 79 (BW), Dağdaş-94 (BW) and Kızıltan-91 (DW), most tolerant varieties in dry conditions, have been widely grown in winter/facultative region. Those varieties have in their crosses local varieties as Yayla-305, Ankara-093/44 and Uveyik, respectively.
Key words: Breeding, climate change, drought, landraces, local varieties, wheat
Preterm Birth: The Real Challenge!
Dr. Shehla Jamal
Assistant Professor, Obstetrics and Gynecology, School of Medical Sciences and Research, Sharda University
Complications of preterm birth put a humongous burden on the limited resources on a developing nation as ours. Around 15 million of babies are born prematurely, which is responsible for & gt: 50% of neonatal death. Scenario is no different in India which experiences around 3.1 million preterm births annually and approximately one million are dying each year. Gestational age at birth and ABSTRACT Background: Preterm birth is the leading cause of prenatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. The main cited reasons for this trend are increasing indicated preterm births and rising rates of artificially conceived pregnancies. Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy. Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.