Researchers and clinicians have for several decades focused epidemiologic, basic biomedical and clinical investigation on preterm birth, low birth weight, and numerous sequelae of untimely birth. As the problem has been examined from the expertise of various specialists and from separate but at times overlapping disciplines, different etiologic elements have emerged as important in the genesis of prematurity. Despite continuing discoveries in specific disciplines, preterm birth has not been etiologically tied to one factor such as genetic polymorphism, microbial challenge, or immune dysregula-tion. In recent years, the idea of "complex disease" has been proposed as a conceptual model for conditions that involve interplay between genetic, environmental, and other factors. This seems an apt description for preterm birth which will explain the breadth of topics in this special issue.This special issue begins by considering microbial challenges to successful pregnancy. Certainly, the concept of infectious disease as a factor in preterm birth and its sequelae must consider the microorganisms that inhabit the normal host and the way in which host immune system interacts with these microbes. The first five contributions to this issue are focused primarily on microbes that can threaten the pregnancy.
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