Marfan syndrome linked to higher spontaneous preterm birth odds in systematic review

A systematic review in Acta Obstetricia et Gynecologica Scandinavica evaluated whether inherited collagenopathies are associated with spontaneous preterm birth before 37 weeks’ gestation. Researchers searched five databases through April 30, 2025, identifying 14 observational studies comparing pregnancy outcomes in women with and without collagenopathies. The review followed PRISMA 2020 guidance and was prospectively registered in PROSPERO.

Four studies evaluated Marfan syndrome, seven evaluated Ehlers–Danlos syndrome (EDS), one assessed vascular EDS exclusively, and two included mixed collagenopathy cohorts. A fixed-effect meta-analysis restricted to clinically comparable Marfan syndrome studies found higher odds of spontaneous preterm birth versus controls (OR 2.71, 95% CI 2.23–3.30; p < 0.001; I² = 41%). Clinical and methodological heterogeneity precluded meaningful primary quantitative synthesis for EDS, although narrative synthesis consistently identified increased frequencies of spontaneous preterm birth and obstetric complications.

The findings support phenotype-specific obstetric assessment rather than treating inherited collagenopathies as a uniform risk category. Comparative evidence was strongest for Marfan syndrome; EDS findings were less certain because of heterogeneity. The observational evidence establishes association rather than causation. The available abstract does not report total participant numbers or absolute risks, limiting interpretation of the magnitude of risk for individual patients. Prospective studies with standardized subtype classification and outcome reporting are needed.