Medical News 2013, 82, 6, 421 427 PIOTR KORDEL 1, MAŁGORZATA KORALEWSKA-KORDEL 2 PARENTAL TESTING IN THE FORENSIC MEDICINE INSTITUTE OF POZNAN UNIVERSITY OF MEDICAL SCIENCES 1980 2011 USTALANIE OJCOSTWA W ZAKŁADZIE MEDYCYNY SĄDOWEJ UNIWERSYTETU MEDYCZNEGO W POZNANIU W LATACH 1980 2011 1 Laboratory of History of Public Health and Social and Health Policy, Chair of Social Sciences Poznan University of Medical Sciences, Poland Head: prof. Michał Musielak 2 Department and Institute of Forensic Medicine, Poznan University of Medical Sciences, Poland Head: Czesław Żaba, MD, PhD Abstract Introduction. Stating or denying the identity between the biological and legal parentage has been a problem for centuries. Not until the latter half of 20th century, thanks to advances in medical sciences, this problem couldn t be solved. The classic serological analysis, the HLA system analysis and DNA analysis enabled people to exclude or confirm paternity. Aim. Presentation of the structure of non-paternity events in expert opinions provided by the Forensic Medicine Institute of Poznan University of Medical Sciences in the years 1980 2011, judging the influence of the method used for parental testing on the percentage of non-paternity events and presentation the influence of demographic changes in Poland on the number of paternity tests run by the Forensic Medicine Institute of Poznan University of Medical Sciences. Material and methods. The research material were the results of the paternity test conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences in the years 1980 2011: 4387 serological test, 679 HLA system tests and 1252 DNA analyses. Results. The percentage of non-paternity events in serological test in the years 1980 2004 reached 24.25%. In HLA system analyses in the years 1980 1997 non-paternity events were 14.29% and in DNA analyses they were 20.85%. Conclusions. The method used for parental testing does not influence the non-paternity events percentage but the demographic changes had influenced the number of parental tests run by the Forensic Medicine Institute of Poznan University of Medical Sciences. KEY WORDS: parental testing, serological analysis, HLA analysis, DNA analysis. Streszczenie Wstęp. Ustalenie tożsamości między ojcostwem biologicznym i prawnym przez wieki było problemem nierozwiązywalnym. Dopiero w drugiej połowie XX w., dzięki postępom w naukach medycznych, udało się rozwiązać ten problem. Klasyczna ekspertyza serologiczna, badania układu HLA i analiza DNA pozwoliły na wykluczenie, a następnie potwierdzenie ojcostwa. Cel. Przedstawienie struktury wykluczeń ojcostwa w ekspertyzach Zakładu Medycyny Sądowej UM w Poznaniu w latach 1980 2011, ocena wpływu stosowanej metody analizy na procent wykluczeń oraz przedstawienie wpływu przemian demograficznych w Polsce na liczbę wykonywanych badań w Zakładzie Medycyny Sądowej UM w Poznaniu. Materiał i metody. Materiał badawczy stanowiły wyniki badań ustalenia ojcostwa przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w latach 1980 2011: 4387 ekspertyzy serologiczne, 679 badań układu HLA i 1252 analizy DNA. Wyniki. Odsetek wykluczeń ojcostwa przy zastosowaniu klasycznej ekspertyzy serologicznej wynosił w latach 1980 2004 24,25%. W przypadku ekspertyz układu HLA w latach 1980 1997 wykluczenia ojcostwa stanowiły 14,29% wyników. Z kolei w wyniku analiz DNA w latach 1997 2011 wykluczenia ojcostwa stanowiły 20,85% wyników badań. Wnioski. Stosowana metoda ustalania ojcostwa nie wpłynęła na odsetek wykluczeń w badaniach. Wpływ przemian demograficznych na liczbę badań ustalenia ojcostwa w Zakładzie Medycyny Sądowej UM w Poznaniu jest wyraźnie zauważalny. SŁOWA KLUCZOWE: ustalanie ojcostwa, ekspertyza serologiczna, ekspertyza HLA, analiza DNA. Introduction Each year in Poland courts hear several thousand cases related to the problem of paternity. Those cases concern mainly affiliation and denial of paternity. The trial in those cases in ended by a verdict stating or denying the identity between the biological and legal parentage. The problem of parentage is dated back to the ancient times. The only methods available used for checking whether the man was the biological father of a child
422 Piotr Kordel, Małgorzata Koralewska-Kordel were, for many ages, the anthropological methods basing on the physical resemblance between the father and the child, which were an imperfect tool, and the knowledge on the time of conception. The second method was also faulty because promiscuous nature of human beings. The thing that proves best the weakness of those methods is the Roman maxim Mater semper certa est, pater semper incertus est and the legal presumption of legitimacy pater est, quem nuptiae demonstrant, which is also present in Polish family law (art. 62 of the Polish Family and Guardianship Code, Polish Official Journal No 2012.788). The advances of medical sciences enabled people to solve the problem of stating the biological paternity. The first method used for exclusion of paternity was the serological expertise. Introduction of the study of blood groups into courtroom practice as an evidence was possible thanks to many discoveries such as Gregor Mendel s inheritance patterns or Karl Landsteiner s distinction of the main blood groups. In 1911 Ludwik Hirszfeld proved that blood groups are inherited according to rules stated by Mendel. Poland was one of the first countries which allowed serological expertise in courts in 1926 professor Jan Olbrycht ran serological test for an alimony trial for a court in Krakow and professor Ludwik Hirszfeld did the same for a court in Warsaw [1]. Through the years the range of serological expertise changed thanks to discovering new serological systems. The Polish Society of Forensic Medicine and Criminology set 11 systems, which were used for serological expertise: AB0, MNSe, Rh, Kell-Cellano, Hp, Gm(1), Gc, Blood Acid Phosphatase, Phosphoglucomutase, D Esterase, GLO I. The efficiency of the classic serological expertise in excluding paternity reached 88% [2]. In the latter half of the 1970 s the HLA system expertise became a legal evidence. The first HLA expertise in Poland was conducted in Poznan in 1980 [3]. The HLA system analysis was used as the 2 nd degree analysis for the classic serological expertise. The excluding power of those two combined methods reached 97% [4, 5]. The 1990 s brought a significant change in paternity testing. The DNA analysis methods developed by A.J. Jeffreys i K. Mullins [6] enabled scientists not only to exclude parentage but to confirm it with the probability reaching 99.99% [7]. Between 1991 and 1997 in the Forensic Medicine Institute of Poznan University of Medical Sciences the DNA analysis was used as the 3 rd degree analysis together with serological and HLA tests. After 1997, due to high costs, the HLA expertise was abandoned and the serological test were run extremely rare because the DNA analysis turned out to be the most effective method. Aim The aims of the article are: Presentation of the structure of non-paternity events in expert opinions provided by the Forensic Medicine Institute of Poznan University of Medical Sciences in the years 1980 2011 for the legal trials concerning affiliation and denial of paternity. Judging the influence of the method used for parental testing on the percentage of non-paternity events in the expert opinions provided by the Forensic Medicine Institute of Poznan University of Medical Sciences. Presentation of the influence of demographic changes in Poland on the number of paternity tests run by the Forensic Medicine Institute of Poznan University of Medical Sciences. Material and methods The research material were the results of the paternity test conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences in the years 1980 2011: 4387 serological test, 679 HLA system tests and 1252 DNA analyses. The methods used for serological tests concerning red blood cells group antigens were standard methods using diagnostic serums provided by Biotest, Fresenius, Organon, Bheringwerke, Immuno and Ortho. For marking the antigens of the HLA system a microcytotoxicity tests were used with serums provided by Behringwerke, Biotest, Fresenius and Hintel and a rabbit complement. The DNA analyses were run using DNA hybridization and the polymerase chain reaction with multiplex PCR amplification and analysis of STR DNA Loci by AmpF Identifiler system by Applied Biosystems. Results The standard serological expertise was conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences up to 2004. Since 1980 4387 test were conducted in which 1064 excluded paternity of the alleged father. As Table 1 shows it were 24.25% of all tests. Depending on year the percentage of non-paternity events varied from 28% to 11.7%. Table 2 presents the percentage of non-paternity events using the HLA system analysis. As it can be seen the exclusion percentage for this method is much lower and reaches 14.29%. It results from the fact that HLA system analysis was used as the II nd degree analysis, that means that it was used when the classic serological test was unable to exclude paternity. Table 3 presents the percentage of non-paternity events for DNA analysis method which reaches 20.85%. Conclusions Analyzing Tables 1, 2 and 3 it is possible to say that the method used for parental testing does not influence the non-paternity events percentage. It seemed that the increase in test sensitivity should produce growth of the parentage exclusion percentage but we observed a significant drop from 24.25% for serological tests to 20.85% for DNA analysis.
Parental testing in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 2011 423 Table 1. Non-paternity events in serological tests conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 2004 Tabela 1. Zaprzeczenia ojcostwa w ekspertyzach serologicznych przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w latach 1980 2004 Number of serological tests Number of non-paternity events % of non-paternity events 1980 357 98 27.45 1981 394 110 27.92 1982 388 107 27.58 1983 310 89 28.71 1984 313 80 25.56 1985 336 91 27.08 1986 297 70 23.57 1987 266 60 22.56 1988 236 62 26.27 1989 229 62 27.07 1990 244 37 15.16 1991 278 50 17.99 1992 182 31 17.03 1993 98 24 24.49 1994 80 20 25 1995 70 17 24.29 1996 55 10 18.18 1997 59 16 27.12 1998 33 4 12.12 1999 34 4 11.76 2000 45 7 15.56 2001 24 4 16.67 2002 17 3 17.65 2003 20 4 20 2004 22 4 18.18 Total 4387 1064 24.25 Table 2. Non-paternity events in HLA analyses conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 1997 Tabela 2. Zaprzeczenia ojcostwa w analizach HLA przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w latach 1980 1997 Number of HLA tests Number of non-paternity events % of non-paternity events 1980 34 4 11.76 1981 22 7 31.82 1982 45 11 24.44 1983 48 10 20.83 1984 41 17 41.46 1985 32 7 21.88 1986 63 6 9.52 1987 57 9 15.79 1988 78 11 14.1 1989 60 3 5 1990 51 1 1.96 1991 56 3 5.36 1992 39 1 2.56 1993 27 4 14.81 1994 13 1 7.69 1995 9 2 22.22 1996 3 0 0 1997 1 0 0 Total 679 97 14.29
424 Piotr Kordel, Małgorzata Koralewska-Kordel Table 3. Non-paternity events in DNA analyses conducted in the Forensic Medicine Institute of Poznan University of Medical 1991 2011 Tabela 3. Zaprzeczenia ojcostwa w analizach DNA przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w latach 1980 1997 Number of DNA tests Number of non-paternity events % of non-paternity events 1991 5 0 0 1992 9 1 11.11 1993 3 0 0 1994 10 0 0 1995 48 11 22.92 1996 40 13 32.5 1997 40 3 7.5 1998 45 10 22.22 1999 53 13 24.53 2000 72 12 16.67 2001 95 20 21.05 2002 72 14 19.44 2003 87 18 20.69 2004 85 14 16.47 2005 72 14 19.44 2006 76 18 23.68 2007 89 25 28.09 2008 88 18 20.45 2009 81 17 20.99 2010 93 20 21.51 2011 89 20 22.47 Total 1252 261 20.85 Table 4. Illegitimate births in Poland 1970 2011 Tabela 4. Urodzenia pozamałżeńskie w Polsce w latach 1970 2011 Number of illegitimate births Illegitimate as a percentage of total live births 1970 27502 5 1975 30638 4.7 1980 33203 4.8 1985 33948 5 1990 34035 6.2 1991 36291 6.6 1992 37036 7.2 1993 40588 8.2 1994 43206 9 1995 41003 9.5 1996 43548 10.2 1997 45286 11 1998 45696 11.6 1999 44688 11.7 2000 45897 12.1 2001 48326 13.1 2002 51009 14.4 2003 55542 15.8 2004 60995 17.1 2005 67239 18.5 2006 70688 18.9 2007 75488 19.5 2008 82305 19.9 2009 84527 20.2 2010 85085 20.6 2011 82434 21.2 Data from Demographic Yearbooks of Poland published by Central Statistical Offi ce. Opracowanie własne na podstawie roczników demografi cznych GUS.
Parental testing in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 2011 425 Interesting conclusions come from comparing the number of parental tests run in the Forensic Medicine Institute of Poznan University of Medical Sciences with the illegitimate births rate in Poland published by the Central Statistical Office (Główny Urząd Statystyczny). Table 4 illustrates that since 1970 up to 2011 a constant growth of illegitimate births rate can be observed. In 2011 every fifth child was born outside marriage. This could lead to a presumption that the number of court tri- als related to the problem of paternity should grow and so should the number of paternity tests. But as can be seen in Figure 1 there is no such correlation. What is more, a significant drop can be seen. When it comes to the HLA system analyses (Figure 2) the drop results from introducing the DNA analysis method. But when the classic serological expertise is concerned (Figure 3) a significant difference between 1980 s and 1990 s can be observed. It results from a severe drop of the live birth rate in Poland (Figure 4). Figure 1. Number of paternity test conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 2011 Rycina 1. Liczba ekspertyz w sprawach dotyczących ustalenia ojcostwa w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w latach 1980 2011 Figure 2. Number of HLA analyses conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences in cases related to the problem of paternity 1980 1997 Rycina 2. Liczba analiz HLA przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w sprawach dotyczących ustalenia ojcostwa w latach 1980 1997
426 Piotr Kordel, Małgorzata Koralewska-Kordel Figure 3. Number of serological test conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences in cases related to the problem of paternity 1980 2004 Rycina 3. Liczba ekspertyz serologicznych przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w sprawach dotyczących ustalenia ojcostwa w latach 1980 2004 Figure 4. Live birth rate in Poland 1970 2009 Rycina 4. Urodzenia żywe w Polsce w latach 1970 2009 Data from Demographic Yearbooks of Poland published by Central Statistical Offi ce. Opracowanie własne na podstawie roczników demografi cznych GUS.
Parental testing in the Forensic Medicine Institute of Poznan University of Medical Sciences 1980 2011 427 Figure 5. Number of DNA analyses conducted in the Forensic Medicine Institute of Poznan University of Medical Sciences in cases related to the problem of paternity 1991 2011 Rycina 5. Liczba analiz DNA przeprowadzonych w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Poznaniu w sprawach dotyczących ustalenia ojcostwa w latach 1991 2011 The more or less constant level of number of DNA analyses run by the Forensic Medicine Institute of Poznan University of Medical Sciences from 2001 to 2011 (Figure 5) may be a result of counterbalance effect which the growth of illegitimate birth rate has on the drop of the total live birth rate. References 1. Turowska B. Badania grupowe krwi w sprawach spornego ojcostwa przeprowadzone w Katedrze i Zakładzie Medycyny Sądowej w Krakowie w latach 1926 1996. Archiwum Medycyny Sądowej i Kryminologii, XLVII: 139 145. 2. Dobosz T, Świątek B. Dochodzenie spornego ojcostwa poprzez badanie polimorfizmu DNA. Post Med Sąd Krym. T. III: 339 343. 3. Stawarz M, Przybylski Z. Polimorfizm układu HLA locus A, B, C i jego przydatność przy dochodzeniu spornego ojcostwa. Archiwum Medycyny Sądowej i Kryminologii. XXX: 277 284. 4. 5. 6. 7. Kordel M, Kątniak R, Kordel K. Częstość i struktura wykluczeń ojcostwa w układzie HLA. Post Med Sąd Krym. 1988, T. I: 99 103. Pepiński W, Janica J. Częstość antygenów HLA ABC oraz częstość i struktura wykluczeń w badaniach spornego ojcostwa w populacji Polski Północno-Wschodniej. Post Med Sąd Krym. 1995; T. II: 363 369. Mullis KB, Faloona F. Specific synthesis of DNA in vitro a PCR reaction. Methods Enzymol. 155: 335 350. Bjerie A, Syndercombe D, Lincoln P, Morling N. A report of the 1995 and 1996 paternity testing workshop of the English speaking working group of the International Society for Forensic Haemogenetics. Forensic Sci Int. 90: 41 55. Correspondence address: Chair of Social Sciences Poznan University of Medical Sciences 79 Dąbrowskiego Street 60-529 Poznań, Poland phone: +48 61 854 69 11 email: kordel@ump.edu.pl