Genetic Associations with Gestational Duration and Spontaneous Preterm Birth

Ge Zhang(Perinatal Institute), Bjarke Feenstra(Statens Serum Institut), Jonas Bačelis(Perinatal Institute), Xueping Liu(Statens Serum Institut), Lisa M. Muglia(March of Dimes), Julius Juodakis(Perinatal Institute), Daniel E. Miller(Perinatal Institute), Nadia K. Litterman(University of Gothenburg), Panpan Jiang(University of Gothenburg), Laura Russell(University of Gothenburg), David A. Hinds(University of Gothenburg), Youna Hu(Perinatal Institute), Matthew T. Weirauch(Perinatal Institute), Xiaoting Chen(Cincinnati Children's Hospital Medical Center), Arun R. Chavan(Yale University), Günter P. Wagner(Yale University), Mihaela Pavličev(Perinatal Institute), Mauris C. Nnamani(Systems Biology Institute), Jamie Maziarz(Perinatal Institute), Minna K. Karjalainen(Oulu University Hospital), Mika Rämet(Oulu University Hospital), Verena Sengpiel(Perinatal Institute), Frank Geller(Perinatal Institute), Heather A. Boyd(Perinatal Institute), Aarno Palotie(Massachusetts General Hospital), Allison M. Momany(Perinatal Institute), Bruce Bedell(Perinatal Institute), Kelli K. Ryckman(Perinatal Institute), Johanna M. Huusko(Oulu University Hospital), Carmy Forney(Perinatal Institute), Leah C. Kottyan(Cincinnati Children's Hospital Medical Center), Mikko Hallman(Oulu University Hospital), Kari Teramo(University of Helsinki), Ellen A. Nøhr(University of Southern Denmark), George Davey Smith(Medical Research Council), Mads Melbye(University of Copenhagen), Bo Jacobsson(Norwegian Institute of Public Health), Louis J. Muglia(Perinatal Institute)
New England Journal of Medicine
September 6, 2017
Cited by 414Open Access
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Abstract

BACKGROUND: Despite evidence that genetic factors contribute to the duration of gestation and the risk of preterm birth, robust associations with genetic variants have not been identified. We used large data sets that included the gestational duration to determine possible genetic associations. METHODS: ) in the discovery set. RESULTS: In the discovery and replication data sets, four loci (EBF1, EEFSEC, AGTR2, and WNT4) were significantly associated with gestational duration. Functional analysis showed that an implicated variant in WNT4 alters the binding of the estrogen receptor. The association between variants in ADCY5 and RAP2C and gestational duration had suggestive significance in the discovery set and significant evidence of association in the replication sets; these variants also showed genomewide significance in a joint analysis. Common variants in EBF1, EEFSEC, and AGTR2 showed association with preterm birth with genomewide significance. An analysis of mother-infant dyads suggested that these variants act at the level of the maternal genome. CONCLUSIONS: In this genomewide association study, we found that variants at the EBF1, EEFSEC, AGTR2, WNT4, ADCY5, and RAP2C loci were associated with gestational duration and variants at the EBF1, EEFSEC, and AGTR2 loci with preterm birth. Previously established roles of these genes in uterine development, maternal nutrition, and vascular control support their mechanistic involvement. (Funded by the March of Dimes and others.).


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