**2. Biological Continuum of Adverse Pregnancy Outcome**

While we divide pregnancy disorders into distinct categories, much of this classification is arbitrary for the purposes of description and study. Delivery at 19 weeks 6 days of gestation is defined as a miscarriage, whereas delivery one day later is a premature birth. In reality, these conditions occur along a continuum. They have common and interrelated risk factors. For example, a woman with a history of a prior unexplained PTB at 28 weeks is at increased risk of spontaneous PTB in a subsequent pregnancy, but is also at increased risk of preeclampsia and FGR in future pregnancies [4]. These disorders also have overlapping biomarkers [12]. Moreover, deficient spiral artery remodeling has been linked with a spectrum of obstetrical syndromes, including pre- eclampsia, FGR, PTB, premature rupture of membranes (PPROM), abortion, and fetal death [4,8,13]. Taken together, these observations suggest that adverse pregnancy events occur along a biological continuum and likely have a common underlying pathophysiology.
