Chromosome aberrations in a large series of spontaneous miscarriages in the German population and review of the literature

BackgroundIn a review of the literature in 2000 the different cytogenetic aspects of spontaneous miscarriages were well documented. This review also included the spontaneous miscarriage results of one large German study published in 1990. However, to our knowledge there are no new data on spontaneous miscarriages in the German population. Therefore, the aim of the present retrospective large study was to find out the incidence and types of chromosome aberrations in an unselected series of spontaneous miscarriages in the German population, and whether our more recent results were different to data published previously. In case of culture failure we implemented a quantitative fluorescent polymerase chain reaction (QF-PCR) for chromosomes 13, 18, 21, X and Y.ResultsIn the present German retrospective study cytogenetic analysis (CA) was attempted on 534 spontaneous miscarriages between weeks 7 and 34 of gestation, being successful in 73% (390/534) of them. Two hundred and thirty-seven of the cases (61%, 237/390) were chromosomally abnormal. Trisomy was the most common chromosome aberration and accounted for 53% (125/237) of the aberrant karyotypes. A multiple aneuploidy was observed in 7% (17/237) of the aberrant karyotypes. Chromosomes 16, 22, 15 and 21 were found most frequently involved in aneuploidies. Fifty-four cases (23%, 54/237) with a polyploidy were found in the present study. Single unbalanced structural chromosome aberrations accounted for 4% (10/237) of the aberrant karyotypes. Eleven samples (5%, 11/237) displayed a variety of numerical and/or structural chromosome aberrations. One hundred and forty-four spontaneous miscarriages (27%, 144/534) failed to grow in culture. A total of 27 cases were analysed by QF-PCR for chromosomes 13, 18, 21, X and Y, being informative in all cases.ConclusionIn our German retrospective large study of spontaneous miscarriages, the incidence and types of chromosome aberrations by CA are within the reported range of other studies published previously before and after 2000. Therefore, we can conclude that cytogenetic aspects of spontaneous miscarriages have not changed over the years. Additionally 8 of 27 cases (30%) without cell growth showed a numerical chromosome aberration by QF-PCR. Therefore QF-PCR played an important role as a supplementary test when culture failure occurred.

[1]  Jian-sheng Xie,et al.  Genetic analysis of first‐trimester miscarriages with a combination of cytogenetic karyotyping, microsatellite genotyping and arrayCGH , 2009, Clinical genetics.

[2]  Iscn International System for Human Cytogenetic Nomenclature , 1978 .

[3]  F. Bieber,et al.  Incidence of spontaneous abortion among normal women and insulin-dependent diabetic women whose pregnancies were identified within 21 days of conception. , 1988, The New England journal of medicine.

[4]  M. Sousa,et al.  An efficient protocol for the detection of chromosomal abnormalities in spontaneous miscarriages or foetal deaths. , 2009, European journal of obstetrics, gynecology, and reproductive biology.

[5]  K. Hecher,et al.  Detection of aneuploidy in chromosomes X, Y, 13, 18 and 21 by QF-PCR in 662 selected pregnancies at risk. , 2000, Molecular human reproduction.

[6]  L. Kochhan,et al.  Chromosome Aberrations Identified by Cytogenetic Analysis of the First Two Clones of Cultured Amniotic Fluid Cells Compared with QF-PCR Results , 2014, Cytogenetic and Genome Research.

[7]  H. Carp,et al.  Karyotype of the abortus in recurrent miscarriage , 2000 .

[8]  J. Vermeesch,et al.  Diagnosis of miscarriages by molecular karyotyping: Benefits and pitfalls , 2009, Genetics in Medicine.

[9]  Terrence S. Furey,et al.  The DNA sequence and biology of human chromosome 19 , 2004, Nature.

[10]  J. Schouten,et al.  High‐throughput analysis of chromosome abnormality in spontaneous miscarriage using an MLPA subtelomere assay with an ancillary FISH test for polyploidy , 2006, American journal of medical genetics. Part A.

[11]  L. Shaffer,et al.  ISCN 2009 - An International System for Human Cytogenetic Nomenclature , 2009 .

[12]  M. Goddijn,et al.  Genetic aspects of miscarriage. , 2000, Bailliere's best practice & research. Clinical obstetrics & gynaecology.

[13]  H. Cui,et al.  Comparative genomic hybridization analysis of spontaneous abortion , 2006, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[14]  Christina A. Cuomo,et al.  Human chromosome 11 DNA sequence and analysis including novel gene identification , 2006, Nature.

[15]  K. Hirschhorn,et al.  Incidence and spectrum of chromosome abnormalities in spontaneous abortions: New insights from a 12-year study , 2005, Genetics in Medicine.

[16]  M. McNay,et al.  SPONTANEOUS FETAL LOSS RATE IN EARLY PREGNANCY , 1985, The Lancet.

[17]  M. Wick,et al.  Second-Trimester Diagnosis of Triploidy: A Series of Four Cases , 2012, American Journal of Perinatology Reports.

[18]  G. Montalbano,et al.  Comparative genomic hybridization on microarray (a-CGH) in constitutional and acquired mosaicism may detect as low as 8% abnormal cells , 2011, Molecular Cytogenetics.

[19]  D D Baird,et al.  Incidence of early loss of pregnancy. , 1988, The New England journal of medicine.

[20]  M. van Wely,et al.  Genetics of early miscarriage. , 2012, Biochimica et biophysica acta.

[21]  L. Shaffer,et al.  Chromosome Abnormalities and Genetic Counseling , 1989 .

[22]  Vaidehi Jobanputra,et al.  Multiplex interphase FISH as a screen for common aneuploidies in spontaneous abortions. , 2002, Human reproduction.

[23]  T. Porter,et al.  Recurrent Fetal Aneuploidy and Recurrent Miscarriage , 2004, Obstetrics and gynecology.

[24]  K. Hecher,et al.  Increased Nuchal Translucency, Hydrops fetalis or Hygroma colli , 2001, Fetal Diagnosis and Therapy.

[25]  M. Dauge,et al.  Cytogenetic analysis of trophoblasts by comparative genomic hybridization in embryo‐fetal development anomalies , 2001, Prenatal diagnosis.

[26]  B. Eiben,et al.  Cytogenetic analysis of 750 spontaneous abortions with the direct-preparation method of chorionic villi and its implications for studying genetic causes of pregnancy wastage. , 1990, American journal of human genetics.

[27]  D. Ledbetter,et al.  Comparative genomic hybridization-array analysis enhances the detection of aneuploidies and submicroscopic imbalances in spontaneous miscarriages. , 2004, American journal of human genetics.

[28]  C. Ayuso,et al.  MLPA as a screening method of aneuploidy and unbalanced chromosomal rearrangements in spontaneous miscarriages , 2007, Prenatal diagnosis.

[29]  Jinsong Gao,et al.  Array-based comparative genomic hybridization is more informative than conventional karyotyping and fluorescence in situ hybridization in the analysis of first-trimester spontaneous abortion , 2012, Molecular Cytogenetics.

[30]  K. Buysse,et al.  Array comparative genomic hybridization and flow cytometry analysis of spontaneous abortions and mors in utero samples , 2009, BMC Medical Genetics.

[31]  I. Dunham,et al.  The DNA sequence and biological annotation of human chromosome 1 , 2006, Nature.

[32]  M. Rabinowitz,et al.  Informatics Enhanced SNP Microarray Analysis of 30 Miscarriage Samples Compared to Routine Cytogenetics , 2012, PloS one.

[33]  D. Kalousek,et al.  Comparative genomic hybridization in combination with flow cytometry improves results of cytogenetic analysis of spontaneous abortions. , 2000, American journal of human genetics.

[34]  E. Thorland,et al.  Reflex fluorescent in situ hybridization testing for unsuccessful product of conception cultures: A retrospective analysis of 5555 samples attempted by conventional cytogenetics and fluorescent in situ hybridization , 2011, Genetics in Medicine.