Abstract

The q11.2 region on chromosome 22 contains numerous low-copy repeats that lead to deleted or duplicated regions in the chromosome, thereby resulting in different syndromes characterized by intellectual disabilities or congenital anomalies. The association between patient phenotypes and 22q11.2 copy number abnormalities has been previously described in postnatal cases; however, these features have not been systematically evaluated in prenatal cases because of limitations in phenotypic identification in prenatal testing. In this study, we investigated the detection rate of 22q11.2 copy number abnormalities in 2500 fetuses using single nucleotide polymorphism (SNP) array and determined the common abnormal ultrasound findings in fetuses carrying the 22q11.2 copy number abnormalities. The 22q11.2 copy number abnormalities were identified in 13 fetuses with cardiovascular malformations (6/13), kidney malformations (3/13), isolated ultrasound markers (3/13), or high-risk Down syndrome based on maternal serum screening (1/13). Approximately 0.5% (13/2500) of the fetuses harbored 22q11.2 copy number abnormalities. The most frequent ultrasound findings in fetuses with these abnormalities were cardiovascular malformations, followed by kidney malformations and isolated ultrasound markers. Prenatal diagnosis of these genetic abnormalities allows for the delineation of differential diagnoses, characterization of a wide spectrum of associated malformations, and determination of associations that exist between prenatal diagnosis and obstetrical outcomes.

Highlights

  • Chromosome 22 has long been implicated in genomic diseases, such as 22q11.2 deletion syndrome (22q11.2DS) and cat-eye syndrome (CES), which are associated with decreased and increased gene dosages, respectively [1]

  • A total of 2500 fetuses participated in this study, including 1821 fetuses with abnormal sonographic findings, 432 fetuses with advanced maternal age, and 247 fetuses with established high-risk Down syndrome based on maternal serum screening

  • Among 2500 fetuses subjected to single nucleotide polymorphism (SNP) array analysis, 227 fetuses had abnormal copy number variant (CNV)

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Summary

Introduction

Chromosome 22 has long been implicated in genomic diseases, such as 22q11.2 deletion syndrome (22q11.2DS) and cat-eye syndrome (CES), which are associated with decreased and increased gene dosages, respectively [1]. The long arm (q region) of chromosome 22 is vulnerable to chromosomal rearrangement because of the large number of low-copy repeats (LCR) in this region, which mediate non-allelic homologous recombination resulting in unequal crossover rearrangements [6]. These mechanisms lead to deleted or duplicated regions of the chromosome, resulting in different syndromes characterized by intellectual disabilities and/or congenital anomalies [4]. A corresponding chromosomal duplication in 22q11.2 in LCR22A–D has been described, which is associated with diverse phenotypic

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