Shriners Hospitals for Children, Montreal, Quebec, Canada.
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
BMJ Open. 2018 Jun 30;8(6):e021377. doi: 10.1136/bmjopen-2017-021377.
Arthrogryposis multiplex congenita (AMC) describes a heterogeneous group of conditions with multiple congenital contractures. These conditions may be attributed to genetic or other factors inducing decreased fetal movements, including maternal and paternal factors. Discovering the underlying genetic pathways has important repercussions for prevention, gene therapy and genetic counselling. The current literature mainly consists of small-scale, single-site studies, limiting comparability and pooling of findings across individual studies. A pilot registry for children presenting with AMC is proposed to provide the framework for a large-scale AMC registry. This registry will provide the platform to support high-quality studies to inform the distribution, clinical practice and genetics contributing to this group of conditions.
The registry will be piloted on 40 families of children from birth to 21 years of age presenting with AMC. Data will be collected on the child (demographic and newborn variables), mother and father (demographic, lifestyle habits and medical history). To promote standardised data collection, a manual of operations will be developed. Descriptive statistics will be used to summarise relevant data, regression analyses will be used to explore associations to generate hypotheses regarding factors contributing to AMC. Qualitative analysis will also be used to better describe the various phenotypes.
Ethics approval was obtained at the participating sites. The pilot registry will provide the platform for multisite AMC registry that will generate multiple research avenues to enhance current care and establish new therapies. Following this pilot study, the participant selection criteria will be refined and datasets will be expanded to include rehabilitation and surgical interventions, and genetic sequencing. The best timing for the questionnaire administration and frequency of follow-up prior to the implementation of a multisite AMC registry will be determined.
先天性多发性关节挛缩症(AMC)描述了一组具有多种先天性挛缩的异质性疾病。这些疾病可能归因于遗传或其他因素导致胎儿运动减少,包括母体和父体因素。发现潜在的遗传途径对预防、基因治疗和遗传咨询具有重要影响。目前的文献主要由小规模、单站点的研究组成,限制了个体研究之间的可比性和结果的汇总。建议建立一个患有 AMC 的儿童试点登记处,为大规模 AMC 登记处提供框架。该登记处将为支持高质量研究提供平台,以告知该疾病组的分布、临床实践和遗传学。
该登记处将对 40 个患有 AMC 的 0-21 岁儿童的家庭进行试点。将收集有关儿童(人口统计学和新生儿变量)、母亲和父亲(人口统计学、生活方式习惯和病史)的数据。为了促进标准化数据收集,将制定一份操作手册。将使用描述性统计来总结相关数据,回归分析将用于探索关联,以生成关于导致 AMC 因素的假设。还将使用定性分析来更好地描述各种表型。
已在参与地点获得伦理批准。试点登记处将为多站点 AMC 登记处提供平台,该登记处将产生多个研究途径,以加强现有护理并建立新的治疗方法。在这项试点研究之后,将细化参与者选择标准,并扩大数据集,以纳入康复和手术干预以及基因测序。将确定在实施多站点 AMC 登记处之前进行问卷调查的最佳时间和随访频率。