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The genetics of prematurity

It has long been known that the most important risk factor for a preterm delivery is a previous pre-term delivery, suggesting the influence of a genetic predisposition. This is what Zhang et al (N Engl J Med 2017;377:1156–67) investigated recently. They identified six gene variants associated with gestational duration, and a further three variants with preterm birth. The gene products were proteins associated with uterine development, the selenocysteine pathway (suggesting specific aspects of maternal nutrition), and vascular control, so the associations were biologically as well as statistically plausible. The dataset was over 43 000 women: such large numbers are necessary when evaluating genetic associations, but they also show how unlikely it is that preterm birth could ever be predicted accurately from an individual’s genetic information.

The meaning of gastric residual volumes

Have you ever wondered whether the close enquiry about gastric residuals in newborn babies was any advance on the inspection of the entrails of a ritually sacrificed chicken? Here’s an answer, courtesy of Riskin et al (J Pediatr 2017;189:128–34): you, or rather the babies, are better off not knowing. Without the ‘benefit’ …

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