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and oxidative stress are three of the key molecular mechanisms that have been suggested to cause preterm birth. 16 A low-grade chronic hypoxia caused by low hemoglobin levels may increase the risk of maternal infections and stress in both the mother and the fetus. The hypothalamic-pituitary-adrenal axis can be triggered in either the mother or the fetus by an immune system that is overactive in the presence of infections and inflammation and corticotrophin-releasing hormone or cortisol that is generated after a stress reaction. In turn


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