Familial and genetic susceptibility to major neonatal morbidities in preterm twins.
BACKGROUND
Intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia remain significant causes of morbidity and mortality in preterm newborns.


OBJECTIVE
Our goal was to assess the familial and genetic susceptibility to intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia.


METHODS
Mixed-effects logistic-regression and latent variable probit model analysis were used to assess the contribution of several covariates in a multicenter retrospective study of 450 twin pairs born at < or =32 weeks of gestation. To determine the genetic contribution, concordance rates in a subset of 252 monozygotic and dizygotic twin pairs were compared.


RESULTS
The study population had a mean gestational age of 29 weeks and birth weight of 1286 g. After controlling for effects of covariates, the twin data showed that 41.3%, 51.9%, and 65.2%, respectively, of the variances in liability for intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia could be accounted for by genetic and shared environmental factors. Among the 63 monozygotic twin pairs, the observed concordance for bronchopulmonary dysplasia was significantly higher than the expected concordance; 12 of 18 monozygotic twin pairs with > or =1 affected member had both members affected versus 3.69 expected. After controlling for covariates, genetic factors accounted for 53% of the variance in liability for bronchopulmonary dysplasia.


CONCLUSIONS
Twin analyses show that intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia are familial in origin. These data demonstrate, for the first time, the significant genetic susceptibility for bronchopulmonary dysplasia in preterm infants.
Bhandari
Vineet
V
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
Bizzarro
Matthew J
MJ
Shetty
Anupama
A
Zhong
Xiaoyun
X
Page
Grier P
GP
Zhang
Heping
H
Ment
Laura R
LR
Gruen
Jeffrey R
JR
D001997:Bronchopulmonary Dysplasia / Q000235:genetics*; D002543:Cerebral Hemorrhage / Q000235:genetics*; D004200:Diseases in Twins / Q000235:genetics*; D020345:Enterocolitis, Necrotizing / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000235:genetics*; D008297:Male; D012189:Retrospective Studies