Am J Perinatol 2018; 35(10): 936-939
DOI: 10.1055/s-0038-1626705
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Smith–Lemli–Opitz Mutations in Unexplained Stillbirths

Karen J. Gibbins
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
Uma M. Reddy
2  Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
George R. Saade
3  Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Robert L. Goldenberg
4  Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, New York
,
Donald J. Dudley
5  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia
,
Corette B. Parker
6  RTI International, Durham, North Carolina
,
Vanessa Thorsten
6  RTI International, Durham, North Carolina
,
Halit Pinar
7  Department of Pediatric and Developmental Pathology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Radek Bukowski
8  Department of Women's Health, University of Texas–Austin, Austin, Texas
,
Carol J. Hogue
9  Department of Epidemiology, Emory University, Atlanta, Georgia
,
Robert M. Silver
1  Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
› Author Affiliations
Funding This study was supported by grants (HD45925, HD45944, HD45952, HD45953, HD45954, and HD45925) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Further Information

Publication History

15 November 2017

20 December 2017

Publication Date:
12 February 2018 (online)

Abstract

Objective Smith–Lemli–Opitz syndrome (SLOS) is an autosomal recessive syndrome caused by a defect in cholesterol biosynthesis with mutations in 7-dehydrocholesterol reductase (DHCR7). A total of 3% of Caucasians carry DHCR7 mutations, theoretically resulting in a homozygote frequency of 1/4000. However, SLOS occurs in only 1/20,000 to 60,000 live births. Our objective was to assess DHCR7 mutations in unexplained stillbirths.

Study Design Prospective, multicenter, population-based case–control study of all stillbirths and a representative sample of live births enrolled in five geographic areas. Cases with stillbirth due to obstetric complications, infection, or aneuploidy, and those with poor quality deoxyribonucleic acid (DNA) were excluded. DNA was extracted from placental tissue stored at –80°C, and exons 3 to 9 of the DCHR7 gene were amplified, purified, and subjected to bidirectional sequencing to identify mutations.

Results One-hundred forty four stillbirths were unexplained and had adequate DNA for analysis. Nine stillbirths of 139 (6.5%) had a single mutation in one allele in coding exons 3 to 9 of DHCR7 (Table 1). One case (0.7%) was a compound heterozygote for mutations in exons 3 to 9 of DHCR7; this fetus had no clinical or histologic features of SLOS.

Conclusion We detected SLOS mutations in only 0.7% of stillbirths. This does not support a strong association between unrecognized DHCR7 mutations and stillbirth.

Note

The comments and views of the authors do not necessarily represent the views of the NICHD.