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      Detection of submicroscopic chromosomal aberrations by chromosomal microarray analysis for the prenatal diagnosis of central nervous system abnormalities

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          Abstract

          Background

          Central nervous system (CNS) abnormalities are a group of serious birth defects associated with high rates of stillbirths, infant death, or abnormal development, and various disease‐causing copy number variations play a much more important role in the etiology of CNS abnormalities. This study intends to present a retrospective study of the prenatal diagnosis and the pregnancy outcome of fetuses diagnosed with CNS abnormalities, and evaluate the clinical value of chromosomal microarray analysis (CMA) in prenatal diagnosis of CNS abnormalities.

          Methods

          A total of 356 fetuses with CNS abnormalities with or without other ultrasound abnormalities subjected to invasive prenatal diagnosis at the first affiliated hospital of Air Force Medical University from January 2015 to August 2018. All cases have performed both karyotyping and CMA concurrently, but 20 fetuses with chromosome aneuploidy were excluded in the current study.

          Results

          The CMA identified pathogenic copy number variants (pCNVs) in 27/336 (8.03%) fetuses, likely pCNVs in 8/336 (2.38%) fetuses, and variants of unknown significance (VOUS) in 11/336 (3.27%) fetuses. A total of 222 cases had single CNS abnormalities and the pCNVs detection rate was 5.86% (13/222), the remaining 114 cases including CNS abnormalities plus other structural abnormalities, ultrasonographic soft markers and two or more CNS abnormalities, the pCNVs detection rate was 12.3% (14/114).

          Conclusions

          Fetuses with CNS abnormalities have a higher risk of chromosomal abnormalities, our study showed that CNVs play an important role in the etiology of CNS abnormalities. The application of CMA could increase the detection rate of pCNVs causing CNS abnormalities.

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          Most cited references21

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          American College of Medical Genetics standards and guidelines for interpretation and reporting of postnatal constitutional copy number variants.

          Genomic microarrays used to assess DNA copy number are now recommended as first-tier tests for the postnatal evaluation of individuals with intellectual disability, autism spectrum disorders, and/or multiple congenital anomalies. Application of this technology has resulted in the discovery of widespread copy number variation in the human genome, both polymorphic variation in healthy individuals and novel pathogenic copy number imbalances. To assist clinical laboratories in the evaluation of copy number variants and to promote consistency in interpretation and reporting of genomic microarray results, the American College of Medical Genetics has developed the following professional guidelines for the interpretation and reporting of copy number variation. These guidelines apply primarily to evaluation of constitutional copy number variants detected in the postnatal setting.
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            Neurodevelopmental disease genes implicated by de novo mutation and copy number variation morbidity

            We combined de novo mutation (DNM) data from 10,927 cases of developmental delay and autism to identify 253 candidate neurodevelopmental disease genes with an excess of missense and/or likely gene-disruptive mutations. Of these genes, 124 reach exome-wide significance (p < 5 × 10−7) for DNM. Intersecting these results with copy number variation morbidity data shows an enrichment for genomic disorder regions (30/253, LR+ 1.85, p = 0.0017). We identify genes with an excess of missense DNMs overlapping deletion syndromes (e.g., KIF1A and the 2q37 deletion) as well as duplication syndromes, such as recurrent MAPK3 missense mutations within the chromosome 16p11.2 duplication, recurrent CHD4 missense DNMs in the 12p13 duplication region, and recurrent WDFY4 missense DNMs in the 10q11.23 duplication region. Network analyses of genes showing an excess of DNMs highlights functional networks, including cell-specific enrichments in the D1+ and D2+ spiny neurons of the striatum.
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              Additional value of prenatal genomic array testing in fetuses with isolated structural ultrasound abnormalities and a normal karyotype: a systematic review of the literature.

              To establish the prevalence of submicroscopic genetic copy number variants (CNVs) in fetuses with a structural ultrasound anomaly (restricted to one anatomical system) and a normal karyotype. The aim was to determine the diagnostic and prognostic value of genomic array testing in these pregnancies.
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                Author and article information

                Contributors
                zhzhhao@163.com
                yanghong@163.com
                Journal
                J Clin Lab Anal
                J Clin Lab Anal
                10.1002/(ISSN)1098-2825
                JCLA
                Journal of Clinical Laboratory Analysis
                John Wiley and Sons Inc. (Hoboken )
                0887-8013
                1098-2825
                16 July 2020
                October 2020
                : 34
                : 10 ( doiID: 10.1002/jcla.v34.10 )
                : e23434
                Affiliations
                [ 1 ] Department of Obstetrics and Gynecology The First Affiliated Hospital of Air Force Medical University Xi'an China
                Author notes
                [*] [* ] Correspondence

                Hong Yang and Jianfang Zhang, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Air Force Medical University, Xi’an, 710032, Shanxi province, China.

                Emails: yanghongfck@ 123456163.com ; zhzhhao@ 123456163.com

                Author information
                https://orcid.org/0000-0002-9390-3182
                https://orcid.org/0000-0001-5074-4647
                Article
                JCLA23434
                10.1002/jcla.23434
                7595926
                32677110
                dcdcd4d8-6ef3-46a9-8e05-b7f6d18c3b15
                © 2020 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 22 January 2020
                : 11 May 2020
                : 13 May 2020
                Page count
                Figures: 0, Tables: 5, Pages: 9, Words: 5302
                Funding
                Funded by: Key Research and Development Program of Shaanxi Province
                Award ID: 2019ZDLSF01‐06
                Funded by: Scientific and Technological Projects for Social Development of Shaanxi Province
                Award ID: 2016SF‐254
                Funded by: The First Affiliated Hospital of the Air Force Medical University
                Award ID: XJZT18MJ53
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                October 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.3 mode:remove_FC converted:29.10.2020

                Clinical chemistry
                central nervous system abnormalities,chromosomal microarray analysis,copy number variations,loss of heterozygous,prenatal diagnosis

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