Rates of mutant and inherited structural cytogenetic abnormalities detected at amniocentesis: results on about 63,000 fetuses.

We report data on diagnoses made on amniotic fluid specimens from 1977 to 1984 as reported to the New York State Chromosome Registry. The rate of all de novo (presumed mutant) abnormalities was about 2 per 1,000 in about 61,000 fetuses in which results are unlikely to be biased by the reason for amniocentesis (except for maternal age). This includes about 0.5 per 1,000 de novo markers, about 0.5 per 1,000 other de novo unbalanced, and about 1.0 per 1,000 de novo balanced rearrangements. In about 55,000 fetuses in which rates of inherited abnormalities could be evaluated without apparent bias, the rate of all inherited rearrangement was about 2.9 per 1,000. This includes about 0.3 per 1,000 inherited markers, about 0.2 per 1,000 other inherited unbalanced rearrangements, and about 2.4 per 1,000 inherited balanced abnormalities. Only mutant markers showed a clear association with maternal age (37.6 +/- 2.7 in 24 cases v. 35.8 +/- 3.6 in controls). Inherited markers did not exhibit this trend (35.8 +/- 2.0 in 12 cases v. 36.4 +/- 2.8 in controls). Paternal age does not appear to account for the association. Among abnormalities of known origin, the ratio of mutant to inherited cases is for markers 64:36, for other unbalanced rearrangements 73:27, and for all balanced abnormalities 29:71. In a subgroup of about 55,000 fetuses, of 263 total abnormalities there were 8 instances of apparent true somatic mosaics (5 mutant and 3 of unknown origin but almost certainly mutant). There were also 20 instances of markers in which presumptive somatic loss had resulted in mosaicism (10 mutant, 6 of unknown origin and 4 inherited) and 13 other instances of mosaicism associated with apparent somatic loss (9 mutant, 3 of unknown origin, and 1 inherited). The sex ratio (Y to non-Y karyotypes) for all abnormalities detected was 228:210 (1.09), not different from controls. Only deletions (5:14) and 'other' unbalanced rearrangements (5:13) exhibited a suggestive deviation from this trend. The rates of mutant chromosome rearrangements reported from 1977 to 1983 showed no apparent time cluster, with the possible exception of a peak of markers in 1977, a trend that may be due to higher maternal age in this year. Among fetuses studied because of maternal exposure to putative mutagens there was a non-significant excess of mutants (2.9-5.7 per 1,000 v. 1.7-2.2 per 1,000) and a borderline significant excess of inherited rearrangements (8.6-11.5 per 1,000 v. 2.6-3.1 per 1,000).(ABSTRACT TRUNCATED AT 400 WORDS)