Reply

Abstract

We anticipated that our manuscript1Palomar L. DeFranco E.A. Lee K.A. Allsworth J.E. Muglia L.J. Paternal race is a risk factor for preterm birth.Am J Obstet Gynecol. 2007; 197: 152.e1-152.e7Abstract Full Text Full Text PDF Scopus (54) Google Scholar would be controversial because of the paradigm we chose to explore of possible contributions of the fetus to the timing for birth and the risk of preterm birth. After adjustment for many sociodemographic and medical risk factors, we found a persistent increase in risk for prematurity in infants born to white mother–black father pregnancies in a very large population-based cohort. Our conclusion was that this increase in risk may reflect a fetal contribution to preterm birth risk. Had we not found a difference, we would have reported this result as well and concluded that we had no evidence to support a fetal contribution to preterm birth risk. We appreciate that birth timing is influenced by multiple individual, contextual, environmental, and societal factors. It is not clear though what role, if any, inherited genetic factors play in the occurrence of preterm delivery. To gain further insight into biological pathways for parturition, it must be established whether genetic approaches are likely to be useful. As suggested by Montoya and Howard, our intent is to understand genetic and environmental contributions to preterm birth across all ethnoracial groups. It is disappointing that the letters from Chan and Mendez and Spriggs both misconstrue our findings by stating that we conclude the “sole reason” for the increased risk in white mother–black father couples “can only be explained” by genetic factors. They then use this distortion to justify their vitriolic language and the questioning of methodologic issues that were addressed in the manuscript. As we acknowledged in the manuscript, there are inherent limitations of our data source that do not provide information for all potential variables that one could envision, although many of these unmeasured variables would track in a collinear fashion with those that we could analyze. We appreciate that potential exists for ethical abuses of information related to racial and ethnic disparities, although in rigorously exploring these areas, this potential is likely to arise. In publishing our study in the American Journal of Obstetrics & Gynecology, we provide our data to a scholarly audience that we believe is invested in advancing human health and will not be prone to using information inappropriately for reinforcing racial stereotypes. We look forward to productive discussions that will facilitate scientific exploration of disparities and safeguard against inappropriate implications related to race because ultimately this information will inform public health policy. Methodological considerations for evaluating preterm birthAmerican Journal of Obstetrics & GynecologyVol. 198Issue 4PreviewPalomar et al1 concluded that a higher risk of preterm birth observed among white-mother, black-father couples can be explained only by genetic traits linked to the father’s black race. The single-minded focus on a genetic explanation is unsubstantiated given no genetic traits were measured. Additionally, methodological limitations exist to further impede the inferences that can be made on the effect estimates. Full-Text PDF Race as a social construct: the genetic fallacyAmerican Journal of Obstetrics & GynecologyVol. 198Issue 4PreviewPalomar et al1 inappropriately apply the construct of race to conclude that “paternal race is associated with an increased risk of preterm birth in white mothers,” suggesting that black fathers’ genetic contribution is the primary reason for this increase in risk. Full-Text PDF Dangerous implications of racial genetics researchAmerican Journal of Obstetrics & GynecologyVol. 198Issue 4PreviewWe were concerned to read the article by Palomar et al1 correlating black paternal race with preterm labor outcomes. The authors conclude after ostensible controls that “genetic determinants, as reflected by race, may influence birth timing” and that “a father’s race is a risk factor for preterm birth.” In so doing, they make a series of scientifically unsound and potentially harmful inferences. Full-Text PDF