Abstract
This study aimed to evaluate the effects of β2-adrenergic receptor (ADRB2) gene polymorphisms on ritodrine therapy outcomes in patients with preterm labor. Genotyping analysis of ADRB2 gene (rs1042713, rs1042714, rs1042717, rs1042718, and rs1042719) was performed on 137 patients with preterm labor. Survival analysis was conducted for the effects of SNPs on the median time to delivery as a primary outcome. The median time to delivery in the study patients was 349.3 h. Gestational age at admission and modified Bishop scores revealed significant effects on time to delivery (p < 0.001). Among studied SNPs, rs1042717 and rs1042718 showed linkage disequilibrium in this population, and their effects on time to delivery were marginally significant (p < 0.1). Patients with variant-homozygotes in the rs1042713 showed considerably shortened time to delivery compared to wild-allele carriers. The rs1042719 polymorphism significantly affected time to delivery in both univariate and multivariate analysis; the GC and CC carriers showed 64% decrease in time to delivery compared to the wild-type homozygote carriers. Based on the results, it was concluded that the gene polymorphisms of ADRB2 could affect ritodrine therapy in patients with preterm labor. However, given the single-center and the relatively small sample size, our hypothesis requires further independent validation using multi-center and large sample size.
Highlights
Preterm birth is defined as spontaneous labor occurring before 37 completed weeks of gestation.It is the leading cause of neonatal mortality and morbidity in newborns without congenital anomalies or chromosomal abnormalities [1,2]
According to 2012 statistics, the rate of preterm birth ranges between 5% and 18% of babies born across the world [3]
Numerous factors are believed to contribute to the speed and outcome of delivery, but several studies implicated the importance of association between genetic predisposition and preterm birth [6]
Summary
Preterm birth is defined as spontaneous labor occurring before 37 completed weeks of gestation. It is the leading cause of neonatal mortality and morbidity in newborns without congenital anomalies or chromosomal abnormalities [1,2]. Preterm birth has major socioeconomic implications with associated hospital stays [4]. Ritodrine is a β2-adrenergic receptor (ADRB2) agonist, resulting in uterine smooth muscle relaxation. It has been widely used in several European and Asian countries, the efficacy of ritodrine was not consistent [4,5]. Numerous factors are believed to contribute to the speed and outcome of delivery, but several studies implicated the importance of association between genetic predisposition and preterm birth [6]
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