Maternal-foetal Conflict and Genetic Conditioning of Intrauterine Competition in sibling Pairs: A systematic Review

Abstract

The traditionalview of pregnancy as a harmonious collaboration is ill-conceived. For any conception, a parental tug-of-war for nutritional resources ensues at the biological rheostat between inherited matrigenes, patrigenes and rest of uniheritened maternal genome. This quantitative systematic review is an objective forwarded to translate maternal-foetal conflict as driven by genomic imprinting to obstetric complications of preeclampsia and gestational diabetes mellitus. Adverse maternal outcomes owing to duplication of the conflict in presence of two placentae link up to higher incidence of preeclampsia and gestational diabetes mellitus seen with twin pregnancies (pooled summary effect=3.5, and 2.27 respectively). A weak positive association was established betweendichorionicityand preeclampsia (pooled summary effect=1.46).Dizygosityin contradiction to previous literature displayed a small negative association for preeclampsia (pooled summary effect=0.47). No significant contribution of chorionicity was noted in risk of occurrences for gestational diabetes mellitus in terms of marked heterogeneity of the included studies (I²=80.2%). These results warrant further research into differential prioritization of dichorionic and dizygotic pregnancies in respect to adverse maternal outcomes of preeclampsia and gestational diabetes mellitus.