Cargando…
Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births
Objective To investigate the familial clustering of postpartum haemorrhage in the Swedish population, and to quantify the relative contributions of genetic and environmental effects. Design Register based cohort study. Setting Swedish population (multi-generation and medical birth registers). Main o...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131501/ https://www.ncbi.nlm.nih.gov/pubmed/25121825 http://dx.doi.org/10.1136/bmj.g4984 |
_version_ | 1782330471533772800 |
---|---|
author | Oberg, Anna Sara Hernandéz-Diaź, Sonia Frisell, Thomas Greene, Michael F Almqvist, Catarina Bateman, Brian T |
author_facet | Oberg, Anna Sara Hernandéz-Diaź, Sonia Frisell, Thomas Greene, Michael F Almqvist, Catarina Bateman, Brian T |
author_sort | Oberg, Anna Sara |
collection | PubMed |
description | Objective To investigate the familial clustering of postpartum haemorrhage in the Swedish population, and to quantify the relative contributions of genetic and environmental effects. Design Register based cohort study. Setting Swedish population (multi-generation and medical birth registers). Main outcome measure Postpartum haemorrhage, defined as >1000 mL estimated blood loss. Participants The first two live births to individuals in Sweden in 1997-2009 contributed to clusters representing intact couples (n=366 350 births), mothers with separate partners (n=53 292), fathers with separate partners (n=47 054), sister pairs (n=97 228), brother pairs (n=91 168), and mixed sibling pairs (n=177 944). Methods Familial clustering was quantified through cluster specific tetrachoric correlation coefficients, and the influence of potential sharing of known risk factors was evaluated with alternating logistic regression. Relative contributions of genetic and environmental effects to the variation in liability for postpartum haemorrhage were quantified with generalised linear mixed models. Results The overall prevalence of postpartum haemorrhage after vaginal deliveries in our sample was 4.6%. Among vaginal deliveries, 18% (95% confidence interval 9% to 26%) of the variation in postpartum haemorrhage liability was attributed to maternal genetic factors, 10% (1% to 19%) to unique maternal environment, and 11% (0% to 26%) to fetal genetic effects. Adjustment for known risk factors only partially explained estimates of familial clustering, suggesting that the observed shared genetic and environmental effects operate in part through pathways independent of known risk factors. There were similar patterns of familial clustering for both of the main subtypes examined (atony and retained placenta), though strongest for haemorrhage after retained placenta. Conclusions There is a maternal genetic predisposition to postpartum haemorrhage, but more than half of the total variation in liability is attributable to factors that are not shared in families. |
format | Online Article Text |
id | pubmed-4131501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-41315012014-08-14 Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births Oberg, Anna Sara Hernandéz-Diaź, Sonia Frisell, Thomas Greene, Michael F Almqvist, Catarina Bateman, Brian T BMJ Research Objective To investigate the familial clustering of postpartum haemorrhage in the Swedish population, and to quantify the relative contributions of genetic and environmental effects. Design Register based cohort study. Setting Swedish population (multi-generation and medical birth registers). Main outcome measure Postpartum haemorrhage, defined as >1000 mL estimated blood loss. Participants The first two live births to individuals in Sweden in 1997-2009 contributed to clusters representing intact couples (n=366 350 births), mothers with separate partners (n=53 292), fathers with separate partners (n=47 054), sister pairs (n=97 228), brother pairs (n=91 168), and mixed sibling pairs (n=177 944). Methods Familial clustering was quantified through cluster specific tetrachoric correlation coefficients, and the influence of potential sharing of known risk factors was evaluated with alternating logistic regression. Relative contributions of genetic and environmental effects to the variation in liability for postpartum haemorrhage were quantified with generalised linear mixed models. Results The overall prevalence of postpartum haemorrhage after vaginal deliveries in our sample was 4.6%. Among vaginal deliveries, 18% (95% confidence interval 9% to 26%) of the variation in postpartum haemorrhage liability was attributed to maternal genetic factors, 10% (1% to 19%) to unique maternal environment, and 11% (0% to 26%) to fetal genetic effects. Adjustment for known risk factors only partially explained estimates of familial clustering, suggesting that the observed shared genetic and environmental effects operate in part through pathways independent of known risk factors. There were similar patterns of familial clustering for both of the main subtypes examined (atony and retained placenta), though strongest for haemorrhage after retained placenta. Conclusions There is a maternal genetic predisposition to postpartum haemorrhage, but more than half of the total variation in liability is attributable to factors that are not shared in families. BMJ Publishing Group Ltd. 2014-08-13 /pmc/articles/PMC4131501/ /pubmed/25121825 http://dx.doi.org/10.1136/bmj.g4984 Text en © Oberg et al 2014 http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/. |
spellingShingle | Research Oberg, Anna Sara Hernandéz-Diaź, Sonia Frisell, Thomas Greene, Michael F Almqvist, Catarina Bateman, Brian T Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title | Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title_full | Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title_fullStr | Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title_full_unstemmed | Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title_short | Genetic contribution to postpartum haemorrhage in Swedish population: cohort study of 466 686 births |
title_sort | genetic contribution to postpartum haemorrhage in swedish population: cohort study of 466 686 births |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131501/ https://www.ncbi.nlm.nih.gov/pubmed/25121825 http://dx.doi.org/10.1136/bmj.g4984 |
work_keys_str_mv | AT obergannasara geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births AT hernandezdiazsonia geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births AT frisellthomas geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births AT greenemichaelf geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births AT almqvistcatarina geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births AT batemanbriant geneticcontributiontopostpartumhaemorrhageinswedishpopulationcohortstudyof466686births |