THE METHOD OF MENDELIAN RANDOMIZATION IN OBSTETRICS AND GYNECOLOGY

Анотація

Abstract. Introduction. In modern obstetrics and gynecology, increasing importance is being placed on the assessment of causal relationships between modifiable risk factors and the development of maternal and fetal diseases. Traditional observational studies are often limited by confounding factors and reverse causality, while randomized controlled trials in reproductive medicine are frequently ethically or practically unfeasible. In this context, Mendelian randomization (MR) is considered a promising tool for causal inference.

Aim of the study. To analyze the theoretical foundations of the Mendelian randomization method, evaluate its capabilities and limitations, and summarize current evidence regarding the application of MR in obstetric and gynecological research.

Materials and methods. A bibliographic and content analysis of scientific sources published in international peer-reviewed journals was conducted. Comparative analysis and data synthesis methods were applied, with priority given to systematic reviews, meta-analyses, and large-scale cohort studies focusing on the use of Mendelian randomization in reproductive medicine.

Results. The Mendelian randomization method was found to minimize the influence of confounding factors and reverse causality through the use of genetic variants as instrumental variables. In obstetric and gynecological research, MR is applied to assess the causal effects of metabolic, hormonal, and reproductive factors on the risk of preeclampsia, polycystic ovary syndrome, postpartum depression, gestational complications, and gynecologic oncological diseases. At the same time, major limitations of the method have been identified, including pleiotropy, weak genetic instruments, and population stratification.

Conclusions. 1. The Mendelian randomization method in obstetrics and gynecology is associated with increased accuracy in assessing causal relationships between genetically determined risk factors and the development of obstetric and gynecological diseases by minimizing confounding and reverse causality. 2. The application of Mendelian randomization enables the identification of causal effects of metabolic, hormonal, and reproductive factors on the development of pregnancy complications and gynecologic and perinatal pathologies, which has significant clinical implications for prevention and therapeutic decision-making. 3. The justified use of the Mendelian randomization method, considering its methodological limitations and in combination with observational and clinical research findings, is necessary to improve the evidence base and optimize long-term health outcomes for women and children