Author ORCID Identifier

0000-0003-0888-5272

Defense Date

2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Human and Molecular Genetics

First Advisor

Timothy P. York, Ph.D

Second Advisor

Bradley Todd Webb, Ph.D

Third Advisor

Hermine Maes, Ph.D

Fourth Advisor

Kimberly Jefferson, Ph.D

Fifth Advisor

John Quillin, Ph.D

Abstract

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. Significant genetic correlations between cervical change and the length of pregnancy ( |rg | ≥ 0.49) suggest that many of the genes influencing cervical shortening also influence the timing of birth, hinting at biological mechanisms and genetic risk factors that may be shared between these traits. Exploratory analyses have identified potentially relevant associations between cervical shortening and genes involved in progesterone, estrogen, relaxin, and insulin signaling—key hormonal pathways involved in pregnancy maintenance and the timing of delivery. Furthermore, this study demonstrates how polygenic profiles can help identify women who are more likely to develop a short cervix during pregnancy, a primary risk factor for preterm birth that can be effectively managed with timely clinical interventions. Despite its relatively small sample size, this project has produced compelling results, and is currently the largest genetic study of pregnancy in Black/African American women. We hope that the results of this study could one day improve prenatal care for Black women, who are disproportionately affected by preterm birth and significantly underrepresented in genetic and clinical research.

Rights

© Hope M. Wolf

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

12-11-2024

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