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Preterm Birth: Causes, Consequences, and Prevention (2007)
Board on Health Sciences Policy (HSP)

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. "7 Role of Gene-Environment Interactions in Preterm Birth ." Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press, 2007.

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Preterm Birth: Causes, Consequences, and Prevention

ducted suggest that individual genotypes may modify the risk of preterm birth associated with certain enviornmental exposures. Racial and ethnic differences in preterm birth have been discussed extensively throughout this report. This question remains largely unanswered. New tools for high-throughput genotyping, coupled with very-large-scale population-based studies that use sensitive biomarkers, comprehensive exposure assessment, and advanced biotechnology and analytical strategies, are needed to unravel the complex environmental and genetic factors, and gene-gene, and gene-environment interactions responsible for preterm birth. Understanding these factors and their interactions could lead to major improvements in the diagnosis, prevention, and treatment of preterm birth.

The completion of the first draft of the human genome sequence (Lander et al., 2001) and increasing information about the genome’s function have provided new opportunities for the investigation of human health and disease. Likewise, results from the exploration of human genetic variation through the International HapMap Project, spearheaded by The National Human Genome Research Institute (The International HapMap Consortium, 2003), will furnish researchers with a powerful tool for identifying variants that contribute to common diseases. This information will be especially useful when it is combined with reliable, cost-effective, high-through-put methods that can be used to genotype these variants in large population samples (Shi, 2002).

In parallel, there is a growing recognition that changes in the earth’s environment, in combination with genetic susceptibility, may contribute to many chronic diseases and may hold the key to reversing the course of some diseases (Chakravarti and Little, 2003). The improved methods for measuring nongenetic factors and environmental exposures promise to extend the scope of epidemiological investigation (Weaver et al., 1998).

Together, these developments present an exciting opportunity to address unanswered questions related to the complex contributions of genes, the environment, and gene-gene and gene-environment interactions to complex human diseases, including preterm birth. This chapter provides a review of recent progress in understanding the genetics of preterm birth, summarizes important methodological issues, and highlights areas for future research.

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208
Front Matter (R1-R18)
Summary (1-30)
1 Introduction (31-52)
SECTION I Measurement : 2 Measurement of Fetal and Infant Maturity (53-83)
Section I Recommendations (84-86)
SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth (87-123)
4 Sociodemographic and Community Factors Contributing to Preterm Birth (124-147)
5 Medical and Pregnancy Conditions Associated with Preterm Birth (148-168)
6 Biological Pathways Leading to Preterm Birth (169-206)
7 Role of Gene-Environment Interactions in Preterm Birth (207-228)
8 Role of Environmental Toxicants in Preterm Birth (229-254)
Section II Recommendations (255-258)
SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth (259-307)
Section III Recommendations (308-310)
SECTION IV Consequences of Preterm Birth: 10 Mortality and Acute Complications in Preterm Infants (311-345)
11 Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm (346-397)
12 Societal Costs of Preterm Birth (398-429)
Section IV Recommendations (430-432)
SECTION V Research and Policy: 13 Barriers to Clinical Research on Preterm Birth and Outcomes of Preterm Infants (433-454)
14 Public Policies Affected by Preterm Birth (455-472)
Section V Recommendations (473-476)
15 A Research Agenda to Investigate Preterm Birth (477-492)
References (493-590)
Appendix A Data Sources and Methods (591-603)
Appendix B Prematurity at Birth: Determinents, Consequences, and Geographic Variation (604-643)
Appendix C A Review of Ethical Issues involved in Premature Birth (644-687)
Appendix D A Systematic Review of Costs Associated with Preterm Birth (688-724)
Appendix E Selected Programs Funding Preterm Birth Research (725-731)
Appendix F Committee and Staff Biographies (732-740)
Index (741-772)