Department of Obstetrics & Perinatology, Jagiellonian University Medical College, 31-501 Kraków, Poland.
Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Kraków, Poland.
Int J Environ Res Public Health. 2022 Aug 14;19(16):10019. doi: 10.3390/ijerph191610019.
This retrospective cohort study comprehensively evaluates cardiovascular anomalies (CVAs) and associated extracardiac structural malformations (ECMs) among 1005 fetuses undergoing invasive prenatal testing at a single tertiary Polish center in the context of chromosomal aberrations detected in them by array comparative genomic hybridization (aCGH) and G-band karyotyping. The results of our study show that CVAs are among the most common malformations detected in fetuses undergoing invasive prenatal testing, as they affected 20% of all cases seen in our department. Septal defects predominated among fetuses with numerical aberrations, while conotruncal defects were the most common findings among fetuses with pathogenic copy number variants (CNVs). In 61% of cases, CVAs were associated with ECMs (the diagnosis was confirmed postnatally or in cases of pregnancy termination by means of autopsy). The most common ECMs were anomalies of the face and neck, followed by skeletal defects. In total, pathogenic chromosomal aberrations were found in 47.5% of CVAs cases, including 38.6% with numerical chromosomal aberrations. Pathogenic CNVs accounted for 14.5% of cases with CVAs and normal karyotype. Thus, our study highlights the importance of assessing the anatomy of the fetus, and of the genetic testing (preferably aCGH) that should be offered in all CVA and ECM cases.
这项回顾性队列研究全面评估了在波兰一家三级中心进行侵袭性产前检测的 1005 例胎儿中,染色体异常(CVAs)和相关的心脏外结构畸形(ECMs),这些胎儿通过阵列比较基因组杂交(aCGH)和 G 带核型分析检测到了染色体异常。我们的研究结果表明,CVA 是侵袭性产前检测中最常见的畸形之一,因为它们影响了我们科室所有病例的 20%。在存在数量异常的胎儿中,隔缺损最为常见,而在存在致病性拷贝数变异(CNVs)的胎儿中,圆锥动脉干畸形最为常见。在 61%的病例中,CVA 与 ECM 相关(诊断在产后或通过尸检确认,或在终止妊娠的情况下确认)。最常见的 ECM 是面部和颈部畸形,其次是骨骼缺陷。总的来说,47.5%的 CVA 病例存在致病性染色体异常,包括 38.6%的数量染色体异常。致病性 CNVs 占 CVA 和正常核型病例的 14.5%。因此,我们的研究强调了评估胎儿解剖结构和遗传检测(最好是 aCGH)的重要性,应在所有 CVA 和 ECM 病例中提供这些检测。