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Hart AR, Vasudevan C, Griffiths PD, Foulds N, Piercy H, de Lacy P, Boxall S, Howe D, Vollmer B. Antenatal counselling for prospective parents whose fetus has a neurological anomaly: part 2, risks of adverse outcome in common anomalies. Dev Med Child Neurol 2022; 64:23-39. [PMID: 34482539 DOI: 10.1111/dmcn.15043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 12/14/2022]
Abstract
After diagnosis of a fetal neurological anomaly, prospective parents want to know the best and worst-case scenarios and an estimation of the risk to their infant of having an atypical developmental outcome. The literature on developmental outcomes for fetal neurological anomalies is poor: studies are characterized by retrospective design, small sample size, often no standardized assessment of development, and differing definitions of anomalies. This review provides an aide-memoir on the risks of adverse neurodevelopmental outcome for ventriculomegaly, cortical anomalies, microcephaly, macrocephaly, agenesis of the corpus callosum, posterior fossa anomalies, and myelomeningocele, to assist healthcare professionals in counselling. The data in this review should be used alongside recommendations on counselling and service design described in part 1 to provide antenatal counselling.
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Affiliation(s)
- Anthony R Hart
- Department of Perinatal and Paediatric Neurology, Sheffield Children's NHS Foundation Trust, Ryegate Children's Centre, Sheffield, UK
| | - Chakra Vasudevan
- Department of Neonatology, Bradford Royal Infirmary, Bradford, UK
| | - Paul D Griffiths
- Academic Unit of Radiology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
| | - Nicola Foulds
- Department of Clinical Genetics, Princess Anne Hospital, University Southampton NHS Foundation Trust, Southampton, UK
| | - Hilary Piercy
- The Centre for Health and Social Care, Sheffield Hallam University, Sheffield, UK
| | - Patricia de Lacy
- Department of Paediatric Neuosurgery, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Sally Boxall
- Wessex Fetal Medicine Unit, Princess Anne Hospital, Southampton, UK
| | - David Howe
- Wessex Fetal Medicine Unit, Princess Anne Hospital, Southampton, UK
| | - Brigitte Vollmer
- Clinical and Experimental Sciences, Faculty of Medicine, Paediatric and Neonatal Neurology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
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Marangoni M, Smits G, Ceysens G, Costa E, Coulon R, Daelemans C, De Coninck C, Derisbourg S, Gajewska K, Garofalo G, Gounongbe C, Guizani M, Holoye A, Houba C, Makhoul J, Norgaard C, Regnard C, Romée S, Soto J, Stagel-Trabbia A, Van Rysselberge M, Vercoutere A, Zaytouni S, Bouri S, D'Haene N, D'Onle D, Dugauquier C, Racu ML, Rocq L, Segers V, Verocq C, Avni EF, Cassart M, Massez A, Blaumeiser B, Brischoux-Boucher E, Bulk S, De Ravel T, Debray G, Dimitrov B, Janssens S, Keymolen K, Laterre M, van Berkel K, Van Maldergem L, Vandernoot I, Vilain C, Donner C, Tecco L, Thomas D, Désir J, Abramowicz M, Migeotte I. Implementation of fetal clinical exome sequencing: Comparing prospective and retrospective cohorts. Genet Med 2021; 24:344-363. [PMID: 34906519 DOI: 10.1016/j.gim.2021.09.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/23/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE We compared the diagnostic yield of fetal clinical exome sequencing (fCES) in prospective and retrospective cohorts of pregnancies presenting with anomalies detected using ultrasound. We evaluated factors that led to a higher diagnostic efficiency, such as phenotypic category, clinical characterization, and variant analysis strategy. METHODS fCES was performed for 303 fetuses (183 ongoing and 120 ended pregnancies, in which chromosomal abnormalities had been excluded) using a trio/duo-based approach and a multistep variant analysis strategy. RESULTS fCES identified the underlying genetic cause in 13% (24/183) of prospective and 29% (35/120) of retrospective cases. In both cohorts, recessive heterozygous compound genotypes were not rare, and trio and simplex variant analysis strategies were complementary to achieve the highest possible diagnostic rate. Limited prenatal phenotypic information led to interpretation challenges. In 2 prospective cases, in-depth analysis allowed expansion of the spectrum of prenatal presentations for genetic syndromes associated with the SLC17A5 and CHAMP1 genes. CONCLUSION fCES is diagnostically efficient in fetuses presenting with cerebral, skeletal, urinary, or multiple anomalies. The comparison between the 2 cohorts highlights the importance of providing detailed phenotypic information for better interpretation and prenatal reporting of genetic variants.
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Affiliation(s)
- Martina Marangoni
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
| | - Guillaume Smits
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Gilles Ceysens
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Department of Obstetrics and Gynecology, Hôpital Ambroise Paré, Mons, Belgium
| | - Elena Costa
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Robert Coulon
- Department of Obstetrics and Gynecology, Centre Hospitalier EpiCURA, Ath, Belgium
| | - Caroline Daelemans
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Caroline De Coninck
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sara Derisbourg
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Kalina Gajewska
- Department of Obstetrics and Gynecology, Hôpital Civil Marie Curie, Charleroi, Belgium
| | - Giulia Garofalo
- Department of Fetal Medicine, CHU Saint-Pierre, Brussels, Belgium
| | | | - Meriem Guizani
- Department of Fetal Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Anne Holoye
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Catherine Houba
- Department of Fetal Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Jean Makhoul
- Department of Gynecology and Obstetrics, Hôpitaux Iris Sud-Etterbeek-Ixelles, Brussels, Belgium
| | - Christian Norgaard
- Department of Obstetrics and Gynecology, CHIREC - Braine-l'Alleud-Waterloo Hospital, Braine l'Alleud, Belgium
| | - Cecile Regnard
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Stephanie Romée
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jamil Soto
- Department of Gynecology and Obstetrics, Hôpitaux Iris Sud-Etterbeek-Ixelles, Brussels, Belgium
| | - Aurore Stagel-Trabbia
- Department of Gynecology and Obstetrics, Hôpitaux Iris Sud-Etterbeek-Ixelles, Brussels, Belgium
| | | | - An Vercoutere
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Siham Zaytouni
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah Bouri
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicky D'Haene
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dominique D'Onle
- Department of Anatomopathology, Institut Jules Bordet, Brussels, Belgium
| | - Christian Dugauquier
- Department of Pathology, Institut de Pathologie et de Génétique Gosselies, Charleroi, Belgium
| | - Marie-Lucie Racu
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Laureen Rocq
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Valérie Segers
- Department of Anatomopathology, CHU Brugmann, Brussels, Belgium
| | - Camille Verocq
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Marie Cassart
- Department of Fetal Medicine, CHU Saint-Pierre, Brussels, Belgium; Department of Perinatal Imaging Radiology, Etterbeek-Ixelles Hospital, Brussels, Belgium
| | - Anne Massez
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Bettina Blaumeiser
- Center for Medical Genetics, Universiteit en Universitair Ziekenhuis Antwerpen, Antwerp, Belgium
| | | | - Saskia Bulk
- Center of Human Genetics, CHU de Liège, Liège, Belgium
| | - Thomy De Ravel
- Centre for Medical Genetics, Reproduction and Genetics, Reproduction Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), UZ Brussel, Brussels, Belgium
| | | | - Boyan Dimitrov
- Centre for Medical Genetics, Reproduction and Genetics, Reproduction Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), UZ Brussel, Brussels, Belgium
| | - Sandra Janssens
- Center for Medical Genetics, University Hospital Ghent, Ghent, Belgium
| | - Kathelijn Keymolen
- Centre for Medical Genetics, Reproduction and Genetics, Reproduction Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), UZ Brussel, Brussels, Belgium
| | - Marie Laterre
- Center of Human Genetics, CHU de Liège, Liège, Belgium
| | - Kim van Berkel
- Centre for Medical Genetics, Reproduction and Genetics, Reproduction Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), UZ Brussel, Brussels, Belgium
| | | | - Isabelle Vandernoot
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Catheline Vilain
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Catherine Donner
- Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Laura Tecco
- Department of Fetal Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Dominique Thomas
- Department of Gynecology and Obstetrics, Hôpitaux Iris Sud-Etterbeek-Ixelles, Brussels, Belgium
| | - Julie Désir
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Center for Medical Genetics, Institut de Pathologie et de Génétique Gosselies, Charleroi, Belgium
| | - Marc Abramowicz
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Isabelle Migeotte
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Fonds de la Recherche Scientifique (FNRS), Brussels, Belgium.
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