@article {694, title = {Infant mortality: the contribution of genetic disorders.}, journal = {J Perinatol}, volume = {39}, year = {2019}, month = {2019 Dec}, pages = {1611-1619}, abstract = {

OBJECTIVE: To determine the proportion of infant deaths occurring in the setting of a confirmed genetic disorder.

STUDY DESIGN: A retrospective analysis of the electronic medical records of infants born from 1 January, 2011 to 1 June, 2017, who died prior to 1 year of age.

RESULTS: Five hundred and seventy three deceased infants were identified. One hundred and seventeen were confirmed to have a molecular or cytogenetic diagnosis in a clinical diagnostic laboratory and an additional seven were diagnosed by research testing for a total of 124/573 (22\%) diagnosed infants. A total of 67/124 (54\%) had chromosomal disorders and 58/124 (47\%) had single gene disorders (one infant had both). The proportion of diagnoses made by sequencing technologies, such as exome sequencing, increased over the years.

CONCLUSIONS: The prevalence of confirmed genetic disorders within our cohort of infant deaths is higher than that previously reported. Increased efforts are needed to further understand the mortality burden of genetic disorders in infancy.

}, issn = {1476-5543}, doi = {10.1038/s41372-019-0451-5}, author = {Wojcik, Monica H and Schwartz, Talia S and Thiele, Katri E and Paterson, Heather and Stadelmaier, Rachel and Mullen, Thomas E and VanNoy, Grace E and Genetti, Casie A and Madden, Jill A and Gubbels, Cynthia S and Yu, Timothy W and Tan, Wen-Hann and Agrawal, Pankaj B} } @article {653, title = {Unique bioinformatic approach and comprehensive reanalysis improve diagnostic yield of clinical exomes.}, journal = {Eur J Hum Genet}, year = {2019}, month = {2019 Apr 12}, abstract = {

Clinical exome sequencing (CES) is increasingly being utilized; however, a large proportion of patients remain undiagnosed, creating a need for a systematic approach to increase the diagnostic yield. We have reanalyzed CES data for a clinically heterogeneous cohort of 102 probands with likely Mendelian conditions, including 74 negative cases and 28 cases with candidate variants, but reanalysis requested by clinicians. Reanalysis was performed by an interdisciplinary team using a validated custom-built pipeline, "Variant Explorer Pipeline" (VExP). This reanalysis approach and results were compared with existing literature. Reanalysis of candidate variants from CES in 28 cases revealed 1 interpretation that needed to be reclassified. A confirmed or potential genetic diagnosis was identified in 24 of 75 CES-negative/reclassified cases (32.0\%), including variants in known disease-causing genes (n = 6) or candidate genes (n = 18). This yield was higher compared with similar studies demonstrating the utility of this approach. In summary, reanalysis of negative CES in a research setting enhances diagnostic yield by about a third. This study suggests the need for comprehensive, continued reanalysis of exome data when molecular diagnosis is elusive.

}, issn = {1476-5438}, doi = {10.1038/s41431-019-0401-x}, author = {Schmitz-Abe, Klaus and Li, Qifei and Rosen, Samantha M and Nori, Neeharika and Madden, Jill A and Genetti, Casie A and Wojcik, Monica H and Ponnaluri, Sadhana and Gubbels, Cynthia S and Picker, Jonathan D and O{\textquoteright}Donnell-Luria, Anne H and Yu, Timothy W and Bodamer, Olaf and Brownstein, Catherine A and Beggs, Alan H and Agrawal, Pankaj B} }