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An evolutionary genomic perspective on preterm birth; genome editing; and pregnancy in the human species
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DOI:10.3389/fgeed.2026.1805932.png)
Abstract
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The processes of labor and birth have a complex evolutionary history; with substantial variation among species showing differences in gestational length; offspring number; anatomy; and rates of fetal development. Understanding the genomic basis of pregnancy is therefore a focus of evolutionary research; given the importance of reproductive success in processes such as natural selection; mutation; genetic drift; and migration. Disruptions to normal pregnancy processes include preterm birth; which can arise from multiple factors; including infection; anatomical variation; injury; age; parity; and multiple gestation and other obstetrical syndromes as well (e.g.; preeclampsia; and stillbirth). These factors each influence unique and overlapping networks of candidate genes and biological pathways. Here we synthesize evidence from comparative genomics; population genetics; and vertebrate reproductive biology to show that many PTB-relevant genes; including those involved in progesterone signaling; innate immunity; placental regulation; and chromosome 19 gene clusters; have undergone lineage- or population-specific evolutionary change. Integrating evolutionary insights with functional genomics; machine learning; and modern genome-editing technologies; we provide a principled framework to distinguish conserved; high-risk targets from evolutionarily flexible loci; guiding safer mechanistic studies and future interventions to reduce PTB risk. From an initial list of approximately 1; 500 genes involved in pregnancy; we identified those that show evidence of recent evolutionary change for which functional inference is possible. We review some specific nucleotide sites that; when disrupted via CRISPR gene editing; are likely to impact the processes of labor and birth. These loci fall within protein coding genes; transposable elements; transcription factor binding sites; and non-coding RNAs. They are found in nuclear hormone receptors (e.g.; PGR); genes with placenta- and uterine-specific expression patterns (e.g.; LGALS13); as well as signaling molecules and immunological loci. Finally; we provide evidence that gene activity and sequence variation differ across species and provide examples of pathway differences between chimpanzees (nociception) and humans (inflammation).
Keywords:
preterm birth
CRISPR
comparative genomics
gene editing
population genetics
evolutionary genomics
DOHAD
placental evolution
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