Department of Obstetrics and Gynecology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China.
J Clin Lab Anal. 2020 Oct;34(10):e23434. doi: 10.1002/jcla.23434. Epub 2020 Jul 16.
Central nervous system (CNS) abnormalities are a group of serious birth defects associated with high rates of stillbirths, infant death, or abnormal development, and various disease-causing copy number variations play a much more important role in the etiology of CNS abnormalities. This study intends to present a retrospective study of the prenatal diagnosis and the pregnancy outcome of fetuses diagnosed with CNS abnormalities, and evaluate the clinical value of chromosomal microarray analysis (CMA) in prenatal diagnosis of CNS abnormalities.
A total of 356 fetuses with CNS abnormalities with or without other ultrasound abnormalities subjected to invasive prenatal diagnosis at the first affiliated hospital of Air Force Medical University from January 2015 to August 2018. All cases have performed both karyotyping and CMA concurrently, but 20 fetuses with chromosome aneuploidy were excluded in the current study.
The CMA identified pathogenic copy number variants (pCNVs) in 27/336 (8.03%) fetuses, likely pCNVs in 8/336 (2.38%) fetuses, and variants of unknown significance (VOUS) in 11/336 (3.27%) fetuses. A total of 222 cases had single CNS abnormalities and the pCNVs detection rate was 5.86% (13/222), the remaining 114 cases including CNS abnormalities plus other structural abnormalities, ultrasonographic soft markers and two or more CNS abnormalities, the pCNVs detection rate was 12.3% (14/114).
Fetuses with CNS abnormalities have a higher risk of chromosomal abnormalities, our study showed that CNVs play an important role in the etiology of CNS abnormalities. The application of CMA could increase the detection rate of pCNVs causing CNS abnormalities.
中枢神经系统(CNS)异常是一组与高比例的死产、婴儿死亡或发育异常相关的严重出生缺陷,各种致病拷贝数变异在 CNS 异常的病因学中起着更为重要的作用。本研究旨在对诊断为 CNS 异常的胎儿进行产前诊断和妊娠结局的回顾性研究,并评估染色体微阵列分析(CMA)在 CNS 异常产前诊断中的临床价值。
空军军医大学第一附属医院 2015 年 1 月至 2018 年 8 月对 356 例伴有或不伴有其他超声异常的 CNS 异常胎儿进行了有创性产前诊断。所有病例均同时进行核型分析和 CMA,但在本研究中排除了 20 例染色体非整倍体的胎儿。
CMA 在 336 例胎儿中的 27 例(8.03%)中发现了致病性拷贝数变异(pCNVs),8 例(2.38%)中发现了可能致病性 CNVs,11 例(3.27%)中发现了意义不明的变异(VOUS)。222 例胎儿仅存在单一 CNS 异常,pCNVs 检出率为 5.86%(13/222),其余 114 例胎儿包括 CNS 异常加其他结构异常、超声软指标和两个或多个 CNS 异常,pCNVs 检出率为 12.3%(14/114)。
CNS 异常胎儿存在染色体异常的风险较高,本研究表明 CNVs 在 CNS 异常的病因学中起重要作用。CMA 的应用可以提高导致 CNS 异常的 pCNVs 的检出率。