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"You Did This to Me!"

Correspondence to: Susan Kerr Bernal, JD, MPH, PhD(c), 755 South Settlers Circle, Warrington, PA 18976.

Received for publication March 10, 2003; accepted for publication March 10, 2003.

``It seems that paternal genes as expressed by the fetus play a role in the timing of birth and in the risk of repeating a prolonged pregnancy.'' Women of the world rejoice and men hide as the ubiquitous acerbic shouts of ``you did this to me'' take on additional weight from post-term women (more than 41 weeks or more than 294 days).

In a retrospective study of 21 746 postterm sibling pairs and 7009 term sibling pairs, Dr Annette Wind Olesen found a 19.9% reoccurrence of postterm births where the babies had the same father, but where the first birth was term only a 7.7% of subsequent births were postterm. In cases where the paternity of the siblings differed, the recurrent risk of postterm delivery fell to 15.4%, whereas there was a statistically insignificant change in the risk for the term cohort.

Learning that paternal genes contribute to the timing of birth will enhance medical decision-making and should reduce the frequency of obstetrical complications and perinatal morbidity associated with postterm pregnancy in an overly litigious field. With the current malpractice crisis and the exodus of doctors from certain states in noted practice areas such as obstetrics, such knowledge should help reduce malpractice insurance and increase physician choice by preventing physician emigration.

So, is it fair? Is it justified to blame men for their genes? Of course not, but ask an uncomfortable, waddling 42-week postterm pregnant woman, whose body has been taken over by a little alien for 9 months and who has hugely swollen ankles that she cannot see, about fairness and justice, and I am sure she will cast ethics aside as she pleads, ``get this thing out of me.'' Advice to the men: do not begin quoting Hippocrates, Kant, Aristotle, or Sophocles, and go get Ben and Jerry.

Footnotes

¹ Olesen AW, et al. Risk of recurrence of prolonged pregnancy. Br Med J. 2003;326:476. The study controlled for age, interpregnancy interval, social status of the mother, and county of residence, but notably not prenatal care.

^* Journal of Andrology welcomes letters to the editor regarding ``Forum'' articles and other ethical and legal issues of interest in your own practice or research. We also invite you to suggest topics that deserve attention in future issues. Papers appearing in this section are not considered primary research reports and are thus not subjected to peer review. Unsolicited manuscripts are welcome, and will be reviewed and edited by the Section Editor. All submissions should be sent to the Journal of Andrology Editorial Office.

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