The 3'-untranslated region of the HLA-G gene in relation to pre-eclampsia: revisited.

Abnormal human leukocyte antigen G (HLA-G) expression may be involved in pre-eclampsia. A 14 bp insertion/deletion polymorphism exists in exon 8 of the HLA-G gene. Fetal +14/+14 bp HLA-G genotype may predispose to pre-eclampsia in the mother. Other polymorphisms, besides the 14 bp polymorphism (rs66554220), in the 3'-untranslated region (3'-UTR) (exon 8) of the HLA-G gene might be associated with severe pre-eclampsia, especially in primiparas. By haplotype-specific polymerase chain reaction amplification and DNA sequence analysis in the offspring from 50 pre-eclamptic cases and 85 controls (35 and 58 primiparas), 4 single nucleotide polymorphisms (SNPs) were detected in exon 8 of the HLA-G gene [SNP2995 (rs1710), SNP3127 (rs1063320), SNP3172 (rs9380142), and SNP3181 (rs1610696)]. Complete linkage disequilibrium between the +14 bp allele and three of the SNPs (SNP2995, SNP3127, and SNP3172) were observed. Two of the polymorphisms (SNP3172 and SNP3181) were located right before and after an AUUUA-pentamer sequence; AU-rich sequences seem to be involved in mRNA stability. However, only the genotypes of the earlier showed 14 bp polymorphism and the SNP3127 (with a C to G substitution; P = 0.008, P(C) = 0.04) were significantly associated with severe pre-eclampsia in primiparas. In conclusion, this study indicates that the +14 bp HLA-G allele defines a nearly unique exon 8 haplotype, and fetuses homozygous for this haplotype [SNP 2995(C)/SNP 3127(G)/SNP 3172(A)/SNP 3181(G)/+14 bp] are associated with severe pre-eclampsia in primiparas.

Trends in socioeconomic differences in Finnish perinatal health 1991-2006.

BACKGROUND: Socioeconomic differences in perinatal health decreased in Finland in the late 1990s. Whether the decreasing socioeconomic differences in perinatal health observed in Finland in the late 1990s have continued in 2000-6 was studied. METHODS: The data were based on 965 443 births and 931 285 singletons recorded between 1991 and 2006 in the Finnish Medical Birth Register. Information on socioeconomic position was based on maternal occupation. Perinatal health was measured with six different indicators. RESULTS: The proportions of preterm, low birthweight and SGA (small-for-gestational-age) births remained stable during the study period, but decreased for LGA (large-for-gestational-age) births and perinatal death. After adjustment for maternal background variables, the socioeconomic differences in preterm and low-birthweight births decreased in the late 1990s and remained low thereafter. In 2003-6, blue-collar workers had a 14% (95% CI 7% to 22%) higher risk for preterm birth and a 25% (95% CI 16% to 34%) higher risk for low birthweight than upper white-collar workers. For SGA, the socioeconomic differences remained unchanged, and the excess risk for blue-collar workers was 44% (95% CI 31% to 58%) in 2003-6. For LGA, the socioeconomic differences increased, and the highest excess risks were obtained among lower white-collar (23%, 95% CI 15% to 33%) and blue-collar workers (24%, 95% CI 14% to 36%). The differences in perinatal mortality decreased until the late 1990s, but increased thereafter. In 2003-6, lower white-collar and blue-collar workers had the highest excess risks: 46% (95% CI 20% to 77%) and 44% (95% CI 13% to 83%), respectively. CONCLUSIONS: The trends in social inequality in perinatal health outcomes were diverging by indicator. The positive trend on diminishing socioeconomic differences found in the 1990s seems to have come to an end.

Ethnic disparity in stillbirth and infant mortality in Denmark 1981-2003.

OBJECTIVE: Ethnic minorities constitute a growing part of the Danish population but little is known about ethnic disparity in early life mortality in this population. The aim of this study was to investigate ethnic disparities in stillbirth risk and infant mortality in Denmark from 1981 to 2003. METHODS: From population-covering registries, all live and stillbirths of women from the five largest ethnic minority groups and of women from the (Danish) majority population (N = 1,333,452) were identified. The liveborn were followed up for vital status to the age of 1 year. Log-binomial regression was used to estimate relative risks according to ethnic group. The main outcome measure was stillbirth and infant death. RESULTS: Compared with the majority population, the relative risks of stillbirth were 1.28 (95% CI: 1.07 to 1.53) for Turkish, 1.62 (1.25 to 2.09) for Pakistani and 2.11 (1.60 to 2.77) for Somali women. The relative risks of infant mortality were 1.41 (1.22 to 1.63), 1.88 (1.53 to 2.30) and 1.39 (1.03 to 1.89) for children born to Turkish, Pakistani and Somali mothers respectively. The fetal and infant mortality in offspring of Lebanese and Former Yugoslavian women was not different from the mortality in the Danish group. The differences found were, in general, not attributable to ethnic differences in socioeconomic position. Turkish, Pakistani and Somali children had an excess relative risk of infant death due to congenital malformations and the risk of death from perinatal causes was increased among the Pakistani offspring. CONCLUSION: Among the five largest ethnic minorities, the Turkish. Pakistani and Somali population had substantially higher fetal and infant mortality compared with the Danish majority population, while the Lebanese and Former Yugoslavian minorities were at the same level as the majority population. The excess risk was not attributable to socioeconomic conditions.