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Genetic Associations with Gestational Duration and Spontaneous Preterm Birth
Journal article   Open access   Peer reviewed

Genetic Associations with Gestational Duration and Spontaneous Preterm Birth

Ge Zhang, Bjarke Feenstra, Jonas Bacelis, Xueping Liu, Lisa M Muglia, Julius Juodakis, Daniel E Miller, Nadia Litterman, Pan-Pan Jiang, Laura Russell, …
The New England journal of medicine, Vol.377(12), pp.1156-1167
09/21/2017
DOI: 10.1056/NEJMoa1612665
PMCID: PMC5561422
PMID: 28877031
url
https://doi.org/10.1056/NEJMoa1612665View
Published (Version of record) Open Access

Abstract

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. We performed a genomewide association study in a discovery set of samples obtained from 43,568 women of European ancestry using gestational duration as a continuous trait and term or preterm (<37 weeks) birth as a dichotomous outcome. We used samples from three Nordic data sets (involving a total of 8643 women) to test for replication of genomic loci that had significant genomewide association (P<5.0×10 ) or an association with suggestive significance (P<1.0×10 ) in the discovery set. 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. 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.).
Phenotype Pregnancy Adenylyl Cyclases - genetics Datasets as Topic Female Genetic Predisposition to Disease Genetic Variation Genome-Wide Association Study Gestational Age Humans Peptide Elongation Factors - genetics Polymorphism, Single Nucleotide Premature Birth - genetics ras Proteins - genetics Receptor, Angiotensin, Type 2 - genetics Regression Analysis Trans-Activators - genetics Wnt4 Protein - genetics

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