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Patterns of congenital anomalies among individuals with trisomy 13 in Texas
Diego Diaz1, Renata H Benjamin1, Maria Luisa Navarro Sanchez1
1Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas, USA.
Insights
This study analyzed birth defect combinations in trisomy 13. Microcephaly, brain defects, nasal anomalies, and polydactyly frequently co-occurred, aiding understanding of trisomy 13 phenotypes.
Area of Science:
- Genetics
- Developmental Biology
- Medical Genetics
Background:
- Trisomy 13 (Patau syndrome) is a severe chromosomal disorder.
- Limited population-based data exists on co-occurring birth defects in trisomy 13.
- Understanding defect patterns is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the frequency and patterns of co-occurring birth defects in individuals with trisomy 13.
- To identify specific combinations of birth defects that occur more often than expected by chance.
- To refine the phenotypic spectrum of trisomy 13.
Main Methods:
- Analysis of 736 individuals with trisomy 13 from the Texas Birth Defects Registry (1999-2014).
- Calculation of observed-to-expected ratios for combinations of one to four additional birth defects.
- Adjustment for non-specific birth defect clustering and sensitivity analyses for live births.
Main Results:
- The most prominent combination of defects included microcephaly, brain malformations (e.g., holoprosencephaly), nasal anomalies, and polydactyly.
- Many high-ratio combinations involved known trisomy 13 features like scalp defects (aplasia cutis) and heart anomalies.
- Results remained consistent when analyzing live births only.
Conclusions:
- Identified specific co-occurring birth defect patterns in trisomy 13 beyond expected clustering.
- Findings contribute to a more detailed understanding of the trisomy 13 phenotype.
- May inform improved screening, genetic counseling, and future research for trisomy 13.
Abstract:
Few population-based studies have analyzed patterns of co-occurring birth defects among those with trisomy 13. We evaluated the frequency of all possible combinations of any one, two, three, or four additional co-occurring birth defects among 736 individuals with trisomy 13 using data from the Texas Birth Defects Registry for deliveries during 1999-2014. We calculated the observed-to-expected ratio for each combination, adjusting for the known tendency for birth defects to cluster non-specifically. To address potential ascertainment differences among live births and non-live births, we repeated analyses specifically among live births. The combination of defects with the largest observed-to-expected ratio was microcephalus, reduction deformities of brain (e.g., holoprosencephaly), anomalies of nose, and polydactyly. As expected, most of the highest 30 observed-to-expected ratios involved combinations with documented features of trisomy 13, including defects of the scalp (e.g., aplasia cutis) and heart. Results were similar among sensitivity analyses restricted to live births. Our findings may help further delineate the phenotypic spectrum for trisomy 13 and may inform future research related to improving screening and counseling for the condition.
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