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American Journal of Epidemiology Advance Access originally published online on November 28, 2007
American Journal of Epidemiology 2008 167(4):474-479; doi:10.1093/aje/kwm319
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2007.

ORIGINAL CONTRIBUTIONS

Familial Patterns of Preterm Delivery: Maternal and Fetal Contributions

Allen J. Wilcox1, Rolv Skjærven2 and Rolv Terje Lie2

1 Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC
2 Department of Public Health and Primary Care Health, Faculty of Medicine, University of Bergen, Bergen, Norway

Correspondence to Dr. Allen J. Wilcox, Epidemiology Branch, MD A3-05, National Institute of Environmental Health Sciences, P.O. Box 12233, Durham, NC 27709 (e-mail: wilcox{at}niehs.nih.gov).

Received for publication June 29, 2007. Accepted for publication September 28, 2007.

Women who deliver preterm (<37 completed weeks' gestation) are at high risk for recurrence. This has prompted exploration of candidate genes (both maternal and fetal) associated with preterm delivery. Epidemiologists can use recurrence patterns of preterm delivery across generations to assess the relative contributions of maternal and fetal genes. The authors used data from the Medical Birth Registry of Norway (1967–2004) to identify 191,282 mothers and 127,830 fathers who subsequently had at least one singleton offspring. The authors stratified parents according to whether or not they had been born preterm and calculated the risk of preterm delivery among their firstborn. Mothers born preterm had a relative risk for preterm delivery of 1.54 (95% confidence interval (CI): 1.42, 1.67). This association was weaker for fathers born preterm (relative risk (RR) = 1.12, 95% CI: 1.01, 1.25). Among early preterm births (<35 weeks), the effect became stronger for mothers (RR = 1.85, 95% CI: 1.52, 2.27) and weaker for fathers (RR = 1.06, 95% CI: 0.77, 1.44). These data suggest that paternal genes have little, if any, effect on preterm delivery risk. This argues against major contributions of fetal genes inherited from either parent. The increased risk of preterm delivery among mothers born preterm is consistent with heritable maternal phenotypes that confer a propensity to deliver preterm.

family characteristics; genetics; premature birth

Abbreviations: CI, confidence interval; RR, relative risk


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