Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing

Abstract Background Chromosomal microarray analysis (CMA) is being increasingly used to reveal the genetic causes of miscarriage. Nevertheless, approximately half of the time it cannot produce a clear diagnosis. This study aims to investigate the genetic etiology of miscarriage by combining the use...

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Main Authors: Jianlong Zhuang, Wanyu Fu, Ling Gu, Xiaofang Ye, Junyu Wang, Chunnuan Chen
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02709-x
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author Jianlong Zhuang
Wanyu Fu
Ling Gu
Xiaofang Ye
Junyu Wang
Chunnuan Chen
author_facet Jianlong Zhuang
Wanyu Fu
Ling Gu
Xiaofang Ye
Junyu Wang
Chunnuan Chen
author_sort Jianlong Zhuang
collection DOAJ
description Abstract Background Chromosomal microarray analysis (CMA) is being increasingly used to reveal the genetic causes of miscarriage. Nevertheless, approximately half of the time it cannot produce a clear diagnosis. This study aims to investigate the genetic etiology of miscarriage by combining the use of CMA and whole-exome sequencing (WES). Methods A total of 172 pregnant Chinese women who had suffered miscarriages were enrolled in this study. However, those who had received assisted reproductive services were excluded. Among them, 32 cases without pathogenic copy number variants were further subject to WES analysis, then the relevant variants were confirmed by Sanger sequencing. Results Of the 172 enrolled subjects, CMA was successfully performed in 158 cases, with a detection rate of 91.86%. Among them, 82 cases had chromosomal numerical abnormalities. The most common abnormality was chromosome aneuploidy, followed by triploidy and mosaicism. In addition, nine cases carrying pathogenic copy number variants were also identified. Furthermore, WES detection revealed 11 candidate genes that may have caused miscarriage, including the F5, ANXA5, FGA, NSDHL, ATP8B1, JAK2, CC2D2A, FOXP1, CALCRL, TLE6, and CHRNA1 genes. Conclusions Our findings strengthen that CMA is a rapid and effective genetic etiology diagnosis tool for miscarriages, producing the highest chromosomal abnormality detection rate at a gestational age of 10–11+6 weeks. In addition, several gene variants were identified using WES, which may expand the mutation spectrum for miscarriage and provide more valuable information in understanding the phenotype and genotype correlations.
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spelling doaj-art-cb9ee507efd347c2884700e5dc9deddd2025-08-20T03:37:29ZengBMCEuropean Journal of Medical Research2047-783X2025-07-013011910.1186/s40001-025-02709-xEtiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencingJianlong Zhuang0Wanyu Fu1Ling Gu2Xiaofang Ye3Junyu Wang4Chunnuan Chen5Prenatal Diagnosis Center, Quanzhou Women’s and Children’s HospitalPrenatal Diagnosis Center, Quanzhou Women’s and Children’s HospitalDepartment of Bioinformatics, Berry Genomics CorporationDepartment of Neurology, Rare Disease Medical Center, The Second Affiliated Hospital of Fujian Medical UniversityPrenatal Diagnosis Center, Quanzhou Women’s and Children’s HospitalDepartment of Neurology, Rare Disease Medical Center, The Second Affiliated Hospital of Fujian Medical UniversityAbstract Background Chromosomal microarray analysis (CMA) is being increasingly used to reveal the genetic causes of miscarriage. Nevertheless, approximately half of the time it cannot produce a clear diagnosis. This study aims to investigate the genetic etiology of miscarriage by combining the use of CMA and whole-exome sequencing (WES). Methods A total of 172 pregnant Chinese women who had suffered miscarriages were enrolled in this study. However, those who had received assisted reproductive services were excluded. Among them, 32 cases without pathogenic copy number variants were further subject to WES analysis, then the relevant variants were confirmed by Sanger sequencing. Results Of the 172 enrolled subjects, CMA was successfully performed in 158 cases, with a detection rate of 91.86%. Among them, 82 cases had chromosomal numerical abnormalities. The most common abnormality was chromosome aneuploidy, followed by triploidy and mosaicism. In addition, nine cases carrying pathogenic copy number variants were also identified. Furthermore, WES detection revealed 11 candidate genes that may have caused miscarriage, including the F5, ANXA5, FGA, NSDHL, ATP8B1, JAK2, CC2D2A, FOXP1, CALCRL, TLE6, and CHRNA1 genes. Conclusions Our findings strengthen that CMA is a rapid and effective genetic etiology diagnosis tool for miscarriages, producing the highest chromosomal abnormality detection rate at a gestational age of 10–11+6 weeks. In addition, several gene variants were identified using WES, which may expand the mutation spectrum for miscarriage and provide more valuable information in understanding the phenotype and genotype correlations.https://doi.org/10.1186/s40001-025-02709-xChromosomal microarray analysisWhole-exome sequencingEtiological diagnosisMiscarriageMolecular diagnosis
spellingShingle Jianlong Zhuang
Wanyu Fu
Ling Gu
Xiaofang Ye
Junyu Wang
Chunnuan Chen
Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
European Journal of Medical Research
Chromosomal microarray analysis
Whole-exome sequencing
Etiological diagnosis
Miscarriage
Molecular diagnosis
title Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
title_full Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
title_fullStr Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
title_full_unstemmed Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
title_short Etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole-exome sequencing
title_sort etiological diagnosis of miscarriage by combining use of chromosomal microarray analysis and whole exome sequencing
topic Chromosomal microarray analysis
Whole-exome sequencing
Etiological diagnosis
Miscarriage
Molecular diagnosis
url https://doi.org/10.1186/s40001-025-02709-x
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