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Race, genes and preterm delivery

Kevin Fiscella1

  • 1Department of Family Medicine, University of Rochester School of Medicine & Dentistry, Rochester, NY, USA. Kevin_Fiscella@URMC.rochester.edu

Journal of the National Medical Association
|December 13, 2005
PubMed

Insights

Environmental factors, not genetics, likely explain racial disparities in preterm delivery (PTD). Life-long exposures disproportionately affect African Americans, contributing to higher PTD rates and infant mortality.

Area of Science:

  • Reproductive Health
  • Genetics
  • Health Disparities

Background:

  • High rates of preterm delivery (PTD) among African Americans are a significant driver of excess infant mortality in this population.
  • Existing research acknowledges genetic contributions to PTD but does not confirm a genetic basis for the observed racial disparity.
  • Environmental factors are known contributors to PTD, with potential for life-course exposures to disproportionately impact African American women.

Purpose of the Study:

  • To critically evaluate the hypothesis that genetic factors contribute to the racial disparity in preterm delivery (PTD).
  • To examine the role of environmental factors and gene-environment interactions in the context of PTD racial disparities.
  • To assess the evidence for genetic polymorphisms contributing to racial differences in PTD rates.

Main Methods:

  • Review of current evidence on genetic and environmental factors contributing to preterm delivery (PTD).
  • Analysis of studies investigating gene-environment interactions relevant to PTD.
  • Examination of research on racial differences in the prevalence of genetic polymorphisms associated with PTD.

Main Results:

  • Environmental factors, including life-course exposures, significantly contribute to preterm delivery (PTD) and disproportionately affect African Americans.
  • Attempting to isolate genetic contributions by controlling for environmental factors at a single time point is methodologically flawed.
  • While gene-environment interactions and racial differences in polymorphisms exist for PTD, direct evidence linking them to the racial disparity is currently lacking.

Conclusions:

  • Environmental factors are the primary drivers of the racial disparity in preterm delivery (PTD), not genetic predispositions.
  • The complexity of polygenic conditions like PTD makes a substantial contribution from any single gene to racial disparity highly improbable.
  • Further research should focus on understanding the cumulative impact of environmental exposures throughout the life course on PTD disparities.

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