Table 1

Summary of clinical, genetic and epigenetic features in families with maternal effect variants

FamilyGeneMaternal effect variant*Hypomethylated loci†Maternal reproductive history of noteFamily history of noteClinical features of note in probandMutation previously reportedFamily previously reported: ref (patient)
1NLRP2NM_017852.4:c.
[1479_1480del];[1479_1480del], p.[(Arg493SerfsTer32)];[(Arg493SerfsTer32)]
M hom; P1 het; P2 het
PLAGL1, GRB10, MEST, KCNQ1OT1, GNASTwo children affected by MLID, one early abortion (gw 8), two late miscarriages (gw 24 and gw 36), one healthy childMother of proband has one healthy sister with three healthy sonsSon: omphalocele, macroglossia, neonatal hypoglycaemia, heart defect, developmental delay. Daughter: macroglossia, dysmorphisms, prominent eyes, developmental delay.4
2NLRP2NM_017852.4:c.[2237del];[=], p.[(Asn746ThrfsTer4)];[=]
M, P het
KCNQ1OT1, H19, MESTIn vitro Fertilisation, triplet, not monozygoticNRSRS (NH-CSS: 6/6)20 (patient 2)
3 (patient 31)
3NLRP2NM_017852.4:c.[2860_2861del];[=], p.[(Cys954GlnfsTer18)];[=]
M het
GRB10, MEST, H19, KCNQ1OT1, MEG3,GNAS-AS, GNASNR, only childSister with three abortions, no live birthsBW at 27 wg 465 g, OFC 32 cm. PNGR, respiratory support for 2 months, gastric tube feeding for first year. Microcephaly, precocious puberty, dysmorphism. Developmental delay. 47,XXY
4NLRP2NM_017852.4:c.[314C>T];[=], p.[(Pro105Leu);[=]
M het
PLAGL1, MEST, DIRAS3, IGF1R, IGF2ROne further child, at least two miscarriages.Sibling of proband has anxiety disorderBW 9th centile, neonatal hyperglycaemia, remission at 3 months, childhood height and weight >99th centile, autistic spectrum disorder, speech and language delay
5NLRP2NM_017852.4:c.[1885T>C(;)2401G>A], p.[(Ser629Pro)(;)(Ala801Thr)]
M, P het both variants
H19, IGF2ROne subsequent healthy child, one miscarriageNRSRS: NH-CSS 4/6; also bilateral radial anomalies, abnormalities of thumbs, single kidney19
6NLRP7NM_001127255.1:c.[2161C>T];[2573T>C]; NP_001120727.1:p.[(Arg721Trp)];[(Ile858Thr)]
M het both variants; P not tested
GRB10, MEST, KCNQ1OT1Two early abortions (gw 4 and gw 4)
1 induced abortion (gw 19)
Sister of proband’s mother was also compound heterozygous; one healthy child (born at gw 26), three early abortions (gw 4, gw 6, gw 7); one ongoing pregnancy, ultrasound  normal, no MLID, p.(Ile858Thr)Induced abortion at 19 gw. Omphalocele, shortened humeri. Mesenchymal placenta.21,22
7NLRP7NM_001127255.1:c.[749T>G];[1104T>G]; p.[(Phe250Cys)];[(Ile368Met)] (M compound het; (P Ile368Met het)KCNQ1OT1, PLAGL1, IGF2R, MEST, DIRAS3, IGF1RNRNRBW 91st centile, exomphalos, macroglossia, neonatal diabetes, feeding difficulties in infancy, motor/speech delay, duplex kidneys, hemihypertrophy, scoliosis20
8NLRP7NM_001127255.1:c.[2156C>T];[=], p.[(Ala719Val)];[=] (M het; P het)H19, IGF1R, IGF2RNR, two additional healthy childrenNRSRS: NH-CSS 5/65, 20
9PADI6NM_207421.3:c.[902G>A(;)1298C>T], p.[(Arg301Gln)(;)(Pro433Leu)] (M compound het; P not tested)H19, MEG3NR, only childMaternal grandpaternal family history of pregnancy loss: one healthy child, one with low birth weight, four stillbirths including a twin pairBW 2nd centile, preserved OFC, micrognathia, hypotonia and feeding difficulties in infancy. In childhood, facial asymmetry, regrognathia, broad fleshy nasal tip, height 10th–25th centile, weight 90th centile.19
10PADI6NM_207421.3:c.[1124T>C];[1639G>A], p.[Leu375Ser)];[(Asp547Asn)] (M compound het; P Asp547Asn het)KCNQ1OT1, GRB10, H19, MEST, IGF2R, IGF1RNR, only childNRBW 90th–97th centile, macrosomia, macroglossia, asymmetry, naevus flammeus, ear creases, developmental delay3 (patient 31)
11PADI6NM_207421.3:c.[1046A>G];[=], p.[(Asp349Gly)];[=] (M het)H19, IGF2R, GRB10, MEST, MEG3, SNRPN, GNAS-AS, GNASTwo healthy children, patient born at termNRReferred for testing as SRS, but NH-CSS negative (3/6): no relative macrocephaly, no feeding difficulties, no protruding forehead; developmental delay
12PADI6NM_207421.3:c.[433A>G];[=], p.[(Lys145Glu)];[=] (M het)H19, IGF2R, MEG3NR, only childNRSRS: NH-CSS 4/6: no feeding difficulties, no asymmetry
13OOEPNM_001080507.2:c.[109C>T];[109C>T], p.[(Arg37Trp)];[(Arg37Trp)] (M hom, P het)PLAGL1, IGF2R, DIRAS3, GRB10, SNRPN, IGF1RNRNRBW <0.4th centile. Hyperglycaemia 1–3.5 months, pelvic renal dilatation, developmental delay
14UHRF1NM_013282.4:c.[514G>A];[=], p.[(Val172Met)];[=] (M het, P het)H19, PLAGL1, IGF2R, KCNQ1OT1, IGF1R, PEG3, GNAS-ASProband is one of discordant monozygotic twin pairNRDiscordant monozygotic twin. SRS: NH-CSS 5/6; also kidney failure in infancy, bilateral renal dysplasia
15ZAR1NM_175619.2:c.[130G>T];[=], p.[(Glu44Cys)];[=] (M het, P het)KCNQ1OT1, GNAS, DIRAS3, IGF1RTwo healthy siblings, one miscarriageNRBW >98th centile, mild macroglossia, consistently high weight (>98th centile)
  • 47The table summarises clinical, genetic and epigenetic features in families with maternal-effect variants. gw: gestational week; NR: not reported; BW: birth weight; OFC: occipitofrontal circumference; PNGR: postnatal growth restriction; NH-CSS: Netchine-Harbison Clinical Scoring System47 (Netchine-Harbison score from 6 parameters: intrauterine growth restriction, postnatal growth restriction, relative macrocephaly, feeding difficulties, asymmetry, protruding forehead). *M: variant detected in mother (by definition); P: variant detected in proband; hom: homozygous; het: heterozygous.

  • †All loci were tested, but the table lists only loci at which hypomethylation was detected.