Retrospective study of prenatal ultrasound findings in newborns with a Noonan spectrum disorder

Prenat Diagn. 2016 May;36(5):418-23. doi: 10.1002/pd.4797. Epub 2016 Mar 28.

Abstract

Objectives: Noonan spectrum disorders (NSDs) occur in 1:1000-2500 live births. Currently, there are no guidelines for prenatal molecular genetic testing for NSDs. Recent studies recommend prenatal testing for NSDs when ultrasonography detects two or more associated abnormalities. A stronger association between ultrasound findings and NSDs would enable more informed prenatal genetic testing.

Methods: A total of 212 newborns (0-12 weeks) with prenatal ultrasound findings and a clinical suspicion of a NSD were referred for molecular genetic testing. Of these, 159/212 newborns tested had a single ultrasound abnormality and 53/212 newborns had two or more. Testing was performed by either a microarray-based resequencing assay or next generation sequencing of RAS/MAPK pathway genes associated with NSDs. Prenatal ultrasound findings in positive and negative cases were compared.

Results: A disease-causing variant was identified in 21.7% (46/212) of newborns tested. Of these positive cases, 67.4% (31/46) had only one ultrasound abnormality reported. The rate of detecting a disease-causing variant in cases with one ultrasound finding was 19.5% (31/159), which was not significantly different (p-value = 0.36) than that in cases with two or more ultrasound findings (28.3%; 15/53).

Conclusions: Prenatal molecular testing for NSDs should be considered even in the presence of a single associated abnormal ultrasound finding. © 2016 John Wiley & Sons, Ltd.

MeSH terms

  • DNA Mutational Analysis
  • Female
  • GTP Phosphohydrolases / genetics
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Infant
  • Infant, Newborn
  • MAP Kinase Kinase 1 / genetics
  • Male
  • Membrane Proteins / genetics
  • Noonan Syndrome / diagnostic imaging
  • Noonan Syndrome / genetics*
  • Oligonucleotide Array Sequence Analysis
  • Pregnancy
  • Protein Tyrosine Phosphatase, Non-Receptor Type 11 / genetics
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins c-raf / genetics
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Retrospective Studies
  • SOS1 Protein / genetics
  • Ultrasonography, Prenatal*

Substances

  • KRAS protein, human
  • Membrane Proteins
  • SOS1 Protein
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Proto-Oncogene Proteins c-raf
  • MAP Kinase Kinase 1
  • MAP2K1 protein, human
  • PTPN11 protein, human
  • Protein Tyrosine Phosphatase, Non-Receptor Type 11
  • GTP Phosphohydrolases
  • NRAS protein, human
  • HRAS protein, human
  • Proto-Oncogene Proteins p21(ras)