ArticlesClinical Investigation nature publishing group INTRODUCTION: Preterm birth is the major cause of mortality and morbidity in neonates. Intrauterine infection and/or inflammatory response are evident in 60-70% of spontaneous preterm births (sPTBs). Genetic factors significantly increase this risk. however, the genetic background associated with sPTB is poorly understood. surfactant protein (sP) a, sP-D, and mannose-binding lectin (MBL) are structurally and functionally related collectins that bind pathogen-associated molecular patterns, and mostly suppress innate immune responses.
RESULTS:We detected an overrepresentation of the methionine allele of the SFTPD gene (encoding sP-D) Met31Thr polymorphism in preterm infants as compared to term infants. This association was highly significant in infants of families with recurrent sPTBs (P = 0.001, odds ratio = 1.65, 95% confidence interval = 1.22-2.22); however, there was no such association with SFTPD in the mothers of these infants. Polymorphism of the genes encoding sP-a and MBL did not influence the risk of sPTB. DISCUSSION: Our results suggest that the fetal SFTPD Met31Thr polymorphism plays a significant role in genetic predisposition to sPTB. We propose that fetal immune responses influence sensitivity to preterm labor-inducing signals. METHODS: Genes encoding sP-a, sP-D, and MBL were investigated as potential candidates for association with sPTB in a population of preterm singleton infants (n = 406) and their mothers (n = 308), and in mothers with term deliveries (n = 201) and their infants (n = 201), all originating from northern Finland.