A test of maternal human chorionic gonadotropin during pregnancy as an adaptive filter of human gestations

SSM - Population Health

Catalano

2018

Self Cite

Public health researchers may assume, based on the fetal origins literature, that “scarring” of birth cohorts describes the population response to modern-day stressors. We contend, based on extensive literature concerned with selection in utero, that this assumption remains questionable. At least a third and likely many more of human conceptions fail to yield a live birth. Those that survive to birth, moreover, do not represent their conception cohort. Increasing data availability has led to an improved understanding of selection in utero and its implications for population health. The literature describing selection in utero, however, receives relatively little attention from social scientists. We aim to draw attention to the rich theoretical and empirical literature on selection in utero by offering a typology that organizes this diverse work along dimensions we think important, if not familiar, to those studying population health. We further use the typology to identify important gaps in the literature. This work should interest social scientists for two reasons. First, phenomena of broad scholarly interest (i.e., social connectivity, bereavement) affect the extent and timing of selection in utero. Second, the life-course health of a cohort depends in part on the strength of such selection. We conclude by identifying new research directions and with a reconciliation of the apparent contradiction between the “fetal origins” literature and that describing selection in utero.

Section: Endemic Selection In Uterosupporting

confidence: 62%

Selection in utero and population health: Theory and typology of research

SSM - Population Health

Catalano

2018

Self Cite

“…Researchers have proposed that human chorionic gonadotropin (hCG) signals fetal viability and may respond to a relaxed maternal filter (R. A. Catalano et al, ). Among 280,000 mothers in California, hCG trajectories across consecutive live births, by maternal age and parity, cohere with predictions from the RFH (Bruckner, Saxton, Pearl, Currier, & Kharrazi, ). However, clinical administration of hCG to at‐risk fetuses shows no benefit, and the hCG profile of DS cases differs from that of other gestations considered frail (Devaseelan, Fogarty, & Regan, ; Macri et al, ).…”

Section: Discussionsupporting

confidence: 59%

Down syndrome among primiparae at older maternal age: A test of the relaxed filter hypothesis

Singh

Lelong

et al. 2019

Birth Defects Research

Self Cite

Background: Down syndrome (DS) ranks as one of the most common birth defects in the United States. The relaxed filter hypothesis (RFH) asserts that mothers with no previous children but nearing reproductive senescence reduce fetal selectivity against DS pregnancies in the first trimester given the high probability of having no offspring at all if the DS pregnancy is not carried to term. We test the parity prediction of RFH-specifically, that pregnancies to older mothers with no previous live births show an elevated prevalence of DS above values expected from the separate contributions of older maternal age and primiparity. Methods: We retrieved maternal age and parity information on 2,748 DS cases (live, stillborn, or terminated due to anomaly) from the Paris Birth Defects Registry, 1983-2015. We used two waves of the Enquête Fertility Survey (n = 5,460) and counts of stillbirths to calculate total prevalence of DS by maternal age and parity. Results: Primiparous mothers 35+ years show the greatest prevalence of any parity group (9.78 cases per 1,000 deliveries). Tests for additive interaction of primiparity and older maternal age reject the null (relative excess risk due to interaction = 1.01; 95% confidence interval: 0.33, 1.69; null value on additive scale is 0). Conclusions: Relaxed selection may account for 10% of the increase in the prevalence, among older primiparous mothers, of DS detected during or after the 11th week. Future work may hold implications for understanding, among older mothers, the strength of this maternal screen against other defects. K E Y W O R D Sdown syndrome, maternal screen, Paris, relaxed filter hypothesis, selection

“…Data limitations precluded examination of the relation between other candidate measures of cohort selection and male childhood cancers. Cohort values of human chorionic gonadotropin, for instance, may serve as one biomarker that signals offspring quality, albeit with some error ( 40 41 42 ). To the extent that other registries routinely collect such biomarker and/or “omics” information on pregnancies, linkage of this information to birth cohorts and cancer registries may identify other candidates which signal unusually high or low strength of selection in utero .…”

Section: Discussionmentioning

confidence: 99%

Cohort Selection In Utero against Male Twins and Childhood Cancers: A Population-Based Register Study

Cancer Epidemiology, Biomarkers &Amp; Prevention

Catalano

Das

et al. 2021

Self Cite

Background: Cancer ranks as the second leading cause of death among children aged 1 to 14 years in the US. Previous research finds that strong cohort selection in utero against males precedes a reduction in live-born males considered frail. We examine whether such cohort selection in utero may similarly affect the frequency of childhood cancers among male live births. Methods:We examined 1,368 childhood cancers among males born in Sweden over 144 months, from January 1990 to December 2001, and followed to age 15 in the Swedish Cancer Registry. We retrieved the count of male twins by birth month from the Swedish Birth Registry. We applied autoregressive, integrated, moving average (ARIMA) time-series methods to identify and control for temporal patterns monthly childhood cancers and to evaluate robustness of results.Results: Fewer childhood cancers occur among monthly male birth cohorts with elevated selection in utero (i.e., a low count of live-born male twins). This association appears in the concurrent month (coef=.04, 95% CI = 0.001-0.079) as well as in the following month in which most births from the twin's conception cohort are "scheduled" to be born (coef=.055, 95% CI =0.017-0.094).Conclusions: Elevated cohort selection in utero may reduce the number of frail male gestations that would otherwise have survived to birth and received a cancer diagnosis during childhood.Impact: This novel result warrants further investigation of prenatal exposures, including those at the population level, that may induce cohort selection in utero for some cancer types but not others.