1
|
Lu Q, Luo L, Zeng B, Luo H, Wang X, Qiu L, Yang Y, Feng C, Zhou J, Hu Y, Huang T, Ma P, Huang T, Xie K, Yuan H, Huang S, Yang B, Zou Y, Liu Y. Prenatal chromosomal microarray analysis in a large Chinese cohort of fetuses with congenital heart defects: a single center study. Orphanet J Rare Dis 2024; 19:307. [PMID: 39175064 PMCID: PMC11342572 DOI: 10.1186/s13023-024-03317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/08/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Congenital heart defect (CHD) is one of the most common birth defects. The aim of this cohort study was to evaluate the prevalence of chromosomal abnormalities and the clinical utility of chromosomal microarray analysis (CMA) in fetuses with different types of CHD, aiming to assist genetic counseling and clinical decision-making. METHODS In this study, 642 fetuses with CHD were enrolled from a single center over a six-year period (2017-2022). Both conventional karyotyping and CMA were performed simultaneously on these fetuses. RESULTS The diagnostic yield of CMA in fetuses with CHD in our study was 15.3% (98/642). Our findings revealed a significant increase in the diagnostic yield of CMA compared to karyotyping in fetuses with CHD. Among CHD subgroups, the diagnostic yields were high in complex CHD (34.9%), conotruncal defects (28.6%), right ventricular outflow tract obstructive defects (RVOTO) (25.9%), atrioventricular septal defects (AVSD) (25.0%) and left ventricular outflow tract obstructive defects (LVOTO) (24.1%), while those in other CHD (10.6%) and septal defects (10.9%) were relatively low. The overall detection rate of clinically significant chromosomal abnormalities was significantly higher in the non-isolated CHD group compared to the isolated CHD group (33.1% vs. 9.9%, P < 0.0001). Interestingly, numerical chromosomal abnormalities were more likely to occur in the non-isolated CHD group than in the isolated CHD group (20.3% vs. 2.0%, P < 0.0001). The rate of termination of pregnancy (TOP)/Still birth in the non-isolated CHD group was significantly higher than that in the isolated CHD group (40.5% vs. 20.6%, P < 0.0001). Compared to the isolated CHD group, the detection rate of clinically significant chromosomal abnormalities was significantly higher in the group of CHD with soft markers (35.6% vs. 9.9%, P < 0.0001) and in the group of CHD with additional structural anomalies (36.1% vs. 9.9%, P < 0.0001). CONCLUSIONS CMA is a reliable and high-resolution technique that should be recommended as the front-line test for prenatal diagnosis of fetuses with CHD. The prevalence of chromosomal abnormalities varies greatly among different subgroups of CHD, and special attention should be given to prenatal non-isolated cases of CHD, especially those accompanied by additional structural anomalies or soft markers.
Collapse
Affiliation(s)
- Qing Lu
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Laipeng Luo
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Baitao Zeng
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Haiyan Luo
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Xianjin Wang
- Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
| | - Lijuan Qiu
- Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
| | - Yan Yang
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Chuanxin Feng
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Jihui Zhou
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Yanling Hu
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Tingting Huang
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Pengpeng Ma
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Ting Huang
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Kang Xie
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Huizhen Yuan
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Shuhui Huang
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China
| | - Bicheng Yang
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China.
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China.
| | - Yongyi Zou
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China.
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China.
| | - Yanqiu Liu
- Medical Genetic Center, Jiangxi Maternal and Child Health Hospital, No. 318, Bayi Avenue, Nanchang, China.
- Jiangxi Key Laboratory of Birth Defect Prevention and Control, No. 318, Bayi Avenue, Nanchang, China.
| |
Collapse
|
2
|
Wang H, Lin X, Lyu G, He S, Dong B, Yang Y. Chromosomal abnormalities in fetuses with congenital heart disease: a meta-analysis. Arch Gynecol Obstet 2023; 308:797-811. [PMID: 36609702 DOI: 10.1007/s00404-023-06910-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/01/2023] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of this meta-analysis was to evaluate the risk of chromosomal abnormalities in fetuses with congenital heart disease (CHD). METHODS Four literature databases were searched until 17th January 2022 using the relevant medical subject heading terms, word variants, and keywords for "congenital heart defect, fetal, and chromosomal abnormalities". The prevalence of overall chromosomal abnormality, aneuploidy, 22q11 deletion, other copy number variants (CNVs), and variants of unknown significance (VOUS) was analyzed. RESULTS 45 studies met the inclusion criteria for the analysis. The pooled proportion of overall chromosomal abnormalities, aneuploidy, 22q11 deletion, and other CNVs in fetuses with CHD was 23% (95% CI: 20-26%), 19% (95% CI, 16-22%), 2% (95% CI, 2-3%), and 4% (95% CI, 3-5%), respectively. The incidence of overall chromosomal abnormalities, aneuploidy, and other CNVs in non-isolated CHD was higher than in isolated CHD, with odds ratios of 3.08, 3.45, and 4.02, respectively. The incidence of overall chromosomal abnormalities in septal defects was higher than in conotruncal defects and other defects, with odds ratios of 1.60 and 3.61, respectively. In addition, the pooled proportion of VOUS in CHD was 4%. CONCLUSION CHD is commonly associated with chromosomal abnormalities. If karyotyping or fluorescence in situ hybridization is normal, chromosomal microarray should be performed to look for submicroscopic abnormalities, especially in fetuses with non-isolated CHD and septal defects.
Collapse
Affiliation(s)
- Huaming Wang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Zhongshan Load, Quanzhou, Fujian, China
| | - Xi Lin
- Department of Diagnostic Radiology, Fujian Cancer Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Guorong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Zhongshan Load, Quanzhou, Fujian, China.
- Collaborative Innovation Center of Maternal and Child Health Service Technology, Quanzhou Medical College, Quanzhou, China.
| | - Shaozheng He
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Zhongshan Load, Quanzhou, Fujian, China
| | - Bingtian Dong
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Zhongshan Load, Quanzhou, Fujian, China
| | - Yiru Yang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Zhongshan Load, Quanzhou, Fujian, China
| |
Collapse
|
4
|
Mastromoro G, Khaleghi Hashemian N, Guadagnolo D, Giuffrida MG, Torres B, Bernardini L, Ventriglia F, Piacentini G, Pizzuti A. Chromosomal Microarray Analysis in Fetuses Detected with Isolated Cardiovascular Malformation: A Multicenter Study, Systematic Review of the Literature and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12061328. [PMID: 35741137 PMCID: PMC9221891 DOI: 10.3390/diagnostics12061328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022] Open
Abstract
Cardiovascular malformations (CVM) represent the most common structural anomalies, occurring in 0.7% of live births. The CVM prenatal suspicion should prompt an accurate investigation with fetal echocardiography and the assessment through genetic counseling and testing. In particular, chromosomal microarray analysis (CMA) allows the identification of copy number variations. We performed a systematic review and meta-analysis of the literature, studying the incremental diagnostic yield of CMA in fetal isolated CVM, scoring yields for each category of heart disease, with the aim of guiding genetic counseling and prenatal management. At the same time, we report 59 fetuses with isolated CVM with normal karyotype who underwent CMA. The incremental CMA diagnostic yield in fetuses with isolated CVM was 5.79% (CI 5.54–6.04), with conotruncal malformations showing the higher detection rate (15.93%). The yields for ventricular septal defects and aberrant right subclavian artery were the lowest (2.64% and 0.66%). Other CVM ranged from 4.42% to 6.67%. In the retrospective cohort, the diagnostic yield was consistent with literature data, with an overall CMA diagnostic yield of 3.38%. CMA in the prenatal setting was confirmed as a valuable tool for investigating the causes of fetal cardiovascular malformations.
Collapse
Affiliation(s)
- Gioia Mastromoro
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
- Correspondence:
| | - Nader Khaleghi Hashemian
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
| | - Daniele Guadagnolo
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
| | - Maria Grazia Giuffrida
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Barbara Torres
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Laura Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, 71013 San Giovanni Rotondo, Italy; (M.G.G.); (B.T.); (L.B.)
| | - Flavia Ventriglia
- Department of Pediatrics, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy;
- Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Gerardo Piacentini
- Fetal and Pediatric Cardiology Unit, “San Giovanni Calibita” Fatebenefratelli Isola Tiberina Hospital, 00186 Rome, Italy;
- Neonatology and Neonatal Intensive Care Unit, “San Giovanni Calibita” Fatebenefratelli Isola Tiberina Hospital, 00186 Rome, Italy
| | - Antonio Pizzuti
- Department of Experimental Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (N.K.H.); (D.G.); (A.P.)
| |
Collapse
|