Birth seasonality studies in a large Prader-Willi syndrome cohort

Multifactorial influences on successful health outcomes for an adolescent with Prader-Willi syndrome: a qualitative case study

PURPOSE

Prader-Willi syndrome (PWS) is the most common syndromic cause of childhood obesity. This qualitative case study aimed to identify and describe lifestyle themes of an adolescent with PWS that resulted in maintenance of a healthy body mass index (BMI).

CASE DESCRIPTION

The 16-year-old female demonstrated failure to thrive upon birth and underwent 9 months supplemented tube feeding, achieving 50^th percentile weight for height. Throughout childhood she received treatment of physical, occupational, and speech therapies, and has maintained a healthy BMI ranging from 25-50^th percentile weight for height.

METHODS AND RESULTS

Two video interviews were completed separately. Qualitative analysis of the transcribed data identified two overarching themes for maintaining a healthy BMI in this adolescent: 1) adolescent and parent individual characteristics; and 2) family dynamics and lifestyle. Adolescent and parental characteristics included: high level of cognitive function for diagnosis, mild hyperphagia, desire for a regimented schedule, parental type A personalities, intentionality in parental decisions/actions. Family lifestyle characteristics included strong parental involvement and well-defined expectations for their daughter, purposeful integration of physical activity into lifestyle, and presence of a strong family support system.

CONCLUSION

The convergence of multiple optimal influences provided an ideal health outcome in the adolescent.

Birth seasonality studies in a large Prader-Willi syndrome cohort

Prader‐Willi syndrome (PWS) is generally due to sporadic paternal deletions of the chromosome 15q11‐q13 region followed by maternal disomy 15. Advanced maternal age is more commonly seen in those with maternal disomy 15. Environmental factors (e.g., drug use, occupational chemical exposure, infectious agents, and irradiation) could account for chromosome changes. Previous evidence of differences in male and female gametogenesis could suggest an environmental role in the causation of the paternal 15q11‐q13 deletion seen in PWS. Certain occupations such as hydrocarbon‐exposing occupations (e.g., landscaping, farming, and painting) and viral exposure (e.g., human coronavirus 229E causing upper respiratory infections in adults with an incorporation site in the human genome at chromosome 15q11) can be seasonal in nature and contribute to chromosome damage. To assess, we reviewed birth seasonality data in a large cohort of individuals with PWS recruited nationally (N = 355) but no significant differences were seen by month between those with the 15q11‐q13 deletion compared with maternal disomy 15 when analyzing quarterly seasonal patterns. Although early evidence supported birth seasonality differences in PWS, a larger number of individuals in our recent study using advanced genetic testing methods did not find this observation.