Whittington J E, Butler J V, Holland A J
Section of Developmental Psychiatry, Department of Psychiatry, University of Cambridge, Cambridge, UK.
Early Hum Dev. 2008 May;84(5):331-6. doi: 10.1016/j.earlhumdev.2007.08.007. Epub 2007 Oct 4.
Few studies describe in detail the pregnancy and early development of infants with Prader-Willi syndrome (PWS). However, variations at these early stages may partially account for differences in the later phenotype. A recent paper described an abnormally high number of problems in pregnancy and early infancy in a large sample of people with PWS but this sample was not homogeneous with respect to age and potentially liable to cohort effects.
To describe the early development of infants with PWS, younger and more homogeneous for age, and to investigate whether such high rates of perinatal problems are still present despite medical advances and whether there are differences according to the genetic subtypes.
Using a structured interview, data were collected from mothers and from relevant GP and hospital records.
Forty-six babies with PWS, born in a six-year period 2000-2006, and their mothers.
Problems arising during pregnancy, the birth process and the neonatal period and the birth characteristics of the babies.
An abnormally high number of problems associated with the early developmental period similar to those previously reported were observed. The only significant difference between the genetic subtypes was that mother's age was positively correlated with birth weight for UPD (and negatively correlated for deletion subtypes).
High rates of, and variability in, the nature and severity of problems arising during early development have been confirmed. To establish whether variability in the later phenotype is influenced by such differences requires a longitudinal study.
很少有研究详细描述普拉德-威利综合征(PWS)患儿的妊娠及早期发育情况。然而,这些早期阶段的差异可能部分解释了后期表型的不同。最近一篇论文描述了一大群PWS患者在妊娠和婴儿早期存在异常多的问题,但该样本在年龄方面并不均匀,可能存在队列效应。
描述年龄更小且年龄更均匀的PWS患儿的早期发育情况,并调查尽管有医学进步,围产期问题的高发生率是否仍然存在,以及根据基因亚型是否存在差异。
通过结构化访谈,从母亲以及相关全科医生和医院记录中收集数据。
2000年至2006年六年期间出生的46名患有PWS的婴儿及其母亲。
妊娠、分娩过程和新生儿期出现的问题以及婴儿的出生特征。
观察到与早期发育阶段相关的问题数量异常之多,与之前报道的类似。基因亚型之间唯一显著的差异是,母亲年龄与单亲二倍体(UPD)的出生体重呈正相关(与缺失亚型呈负相关)。
已证实早期发育过程中出现的问题在性质和严重程度上发生率高且存在变异性。要确定后期表型的变异性是否受此类差异影响,需要进行纵向研究。