000			03767nam a22005417a 4500
008			160113s20152015 xxu||||| |||| 00| 0 eng d
022			_a0002-9378
040			_aOvid MEDLINE(R)
099			_a26070700
245			_aCluster analysis of spontaneous preterm birth phenotypes identifies potential associations among preterm birth mechanisms.
251			_aAmerican Journal of Obstetrics & Gynecology. 213(3):429.e1-9, 2015 Sep.
252			_aAm J Obstet Gynecol. 213(3):429.e1-9, 2015 Sep.
253			_aAmerican journal of obstetrics and gynecology
260			_c2015
260			_fFY2016
266			_d2016-01-13
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aCONCLUSION: We identified 5 major clusters of SPTB based on a phenotype tool and hierarch clustering. There was significant correlation between several of the phenotypes. The INS gene was associated with familial factors that were underlying SPTB.Copyright � 2015 Elsevier Inc. All rights reserved.
520			_aOBJECTIVE: We sought to use an innovative tool that is based on common biologic pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB) to enhance investigators' ability to identify and to highlight common mechanisms and underlying genetic factors that are responsible for SPTB.
520			_aRESULTS: One thousand twenty-eight women with SPTB were assigned phenotypes. Hierarchic clustering of the phenotypes revealed 5 major clusters. Cluster 1 (n = 445) was characterized by maternal stress; cluster 2 (n = 294) was characterized by premature membrane rupture; cluster 3 (n = 120) was characterized by familial factors, and cluster 4 (n = 63) was characterized by maternal comorbidities. Cluster 5 (n = 106) was multifactorial and characterized by infection (INF), decidual hemorrhage (DH), and placental dysfunction (PD). These 3 phenotypes were correlated highly by chi(2) analysis (PD and DH, P < 2.2e-6; PD and INF, P = 6.2e-10; INF and DH, (P = .0036). Gene-based testing identified the INS (insulin) gene as significantly associated with cluster 3 of SPTB.
520			_aSTUDY DESIGN: We performed a secondary analysis of a prospective case-control multicenter study of SPTB. All cases delivered a preterm singleton at SPTB <34.0 weeks' gestation. Each woman was assessed for the presence of underlying SPTB causes. A hierarchic cluster analysis was used to identify groups of women with homogeneous phenotypic profiles. One of the phenotypic clusters was selected for candidate gene association analysis with the use of VEGAS software.
546			_aEnglish
650			_a*Phenotype
650			_a*Premature Birth/et [Etiology]
650			_aAdult
650			_aCase-Control Studies
650			_aCluster Analysis
650			_aFemale
650			_aGenetic Markers
650			_aGenotype
650			_aHumans
650			_aInsulin/ge [Genetics]
650			_aLogistic Models
650			_aPolymorphism, Single Nucleotide
650			_aPregnancy
650			_aPremature Birth/ge [Genetics]
650			_aProspective Studies
650			_aRisk Factors
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology, Maternal-Fetal Medicine
657			_aJournal Article
657			_aMulticenter Study
657			_aResearch Support, N.I.H., Extramural
700			_aReddy, Uma M
790			_aAndrews W, Biggio J, Bukowski R, Christensen B, Esplin MS, Huang H, Ilekis J, Manuck TA, Parry S, Reddy UM, Saade G, Sadovsky Y, Varner MW, Zhang H
856			_uhttp://dx.doi.org/10.1016/j.ajog.2015.06.011 _zhttp://dx.doi.org/10.1016/j.ajog.2015.06.011
942			_cART _dArticle
999			_c1220 _d1220