Clinical implications of chromosomal inversions. A pericentric inversion in No. 18 segregating in a family ascertained through an abnormal proband.

Chromosomal inversions are being detected in humans with increasing frequency due to the application of chromosomal banding techniques. Inversions have occurred in all chromosomal groups. These structural aberrations may lead to infertility, reproductive loss, or abnormal offspring. To illustrate their clinical significance, we report a family in which an inversion in chromosome No. 18 is segregating. This family was ascertained through a proband whose anomalies were consistent with the deletion 18q syndrome. The chromosomal imbalance originated by recombination within the parental inversion during meiosis. Consideration of this family and 6 others with similar breakpoints (18p11 and 18q12 or q21) suggests that the risk of unbalanced (recombinant) livebirths may be higher for female inv(18) heterozygotes than for males. The paucity of male carriers detected could be due to prenatal selection or chance. Overall, there may be preferential segregation for the aberrant chromosomes (inversions plus recombinants). Amniocentesis and cytogenetic analysis of pregnancy losses is recommended for families in which inversions are detected.