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产前诊断的16三体嵌合体的产后随访。

Postnatal follow-up of prenatally diagnosed trisomy 16 mosaicism.

作者信息

Langlois Sylvie, Yong Paul J, Yong Siu Li, Barrett Irene, Kalousek Dagmar K, Miny Peter, Exeler Rita, Morris Kathy, Robinson Wendy P

机构信息

Department of Medical Genetics, University of British Columbia, Canada.

出版信息

Prenat Diagn. 2006 Jun;26(6):548-58. doi: 10.1002/pd.1457.

Abstract

OBJECTIVE

To determine the long-term outcome of pregnancies prenatally diagnosed with trisomy 16 and identify variables associated with the outcome.

METHODS

We reviewed all published and our unpublished data from trisomy 16 pregnancies for which outcomes were available for children of greater than 1 year of age.

RESULTS

Nineteen cases were diagnosed with trisomy 16 on chorionic villus sampling (CVS) and 17 cases at amniocentesis. Age at last follow-up ranges from 1 to 13 years. Among the CVS group, four out of five patients, with a birth weight and/or length below -2 SD and postnatal growth information, showed catch-up growth (80%). Among the amniotic fluid (AF) group, the birth weight was available in 13 cases. Eleven of the 13 cases had a birth weight less than -2 SD. In eight cases, the length was also below -2 SD (length data unavailable in one case). Nine out of ten cases (90%) and seven out of eight (87.5%) showed catch-up growth for weight and length, respectively. In terms of development, no cases of CVS mosaicism had global developmental delay. One child had a history of delay in speech development. Among the AF-detected cases, 4/17 cases had global developmental delay. All four children with global developmental delay had more than one major malformation compared to 6 out of 32 children in the group with normal development (p = 0.004). The finding of uniparental disomy (UPD) was not associated with developmental delay.

CONCLUSIONS

The majority of prenatally diagnosed trisomy 16 mosaic cases have a good postnatal outcome. However, the finding of mosaicism on AF and the presence of major congenital anomalies are associated with an increased risk of developmental delay.

摘要

目的

确定产前诊断为16三体妊娠的长期结局,并识别与该结局相关的变量。

方法

我们回顾了所有已发表的以及我们未发表的关于16三体妊娠的数据,这些妊娠的结局是针对年龄大于1岁的儿童。

结果

19例在绒毛取样(CVS)时被诊断为16三体,17例在羊膜穿刺术时被诊断为16三体。最后一次随访时的年龄范围为1至13岁。在CVS组中,五分之四出生体重和/或身长低于-2标准差且有出生后生长信息的患者出现了追赶生长(80%)。在羊水(AF)组中,13例有出生体重数据。13例中有11例出生体重低于-2标准差。8例身长也低于-2标准差(1例无身长数据)。十分之九(90%)和八分之七(87.5%)的病例分别在体重和身长方面出现了追赶生长。在发育方面,没有CVS嵌合体病例存在全面发育迟缓。1名儿童有语言发育迟缓史。在AF检测出的病例中,17例中有4例存在全面发育迟缓。与发育正常组的32名儿童中的6例相比,所有4例全面发育迟缓的儿童都有不止一种主要畸形(p = 0.004)。单亲二体(UPD)的发现与发育迟缓无关。

结论

大多数产前诊断为嵌合型16三体的病例出生后结局良好。然而,AF检测出嵌合体以及存在主要先天性异常与发育迟缓风险增加有关。

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