An overlooked phenomenon: Female-biased sex ratio among carriers of Robertsonian translocations detected in consecutive newborn studies

Examination of the sex ratio (SR, male to female ratio) among carriers of Robertsonian translocations (rob) in newborns in the general population has not previously been given due attention, probably because of focusing on the striking female preponderance among fertile women explained by sterility of male carriers. Meta-analysis of published studies on 68,212 newborns showed differences in SR depending on the type of rearrangements: there were similar rates of male and female reciprocal translocation carriers (34♂/33♀, 0.97 and 0.99‰, correspondingly), but female preponderance among carriers of rob, regardless of their parental origin was observed (27♂/41♀, 0.77 and 1.24‰, correspondingly). Similar results were obtained from the prenatal cohort. Collectively, among carriers of rob with known parental origin, there were 66♂ and 97♀ (SR = 0.68), different from the expected ratio of 1: 1, p = 0.0093; for carriers of reciprocal translocations and inversions a typical slight male prevalence was found. Female-biased SR was demonstrated for carriers of the most frequent rob, t(13;14), with 50♂/85♀ (SR = 0.59, p = 0.0016), but not for carriers of other robs (28♂/27♀, SR = 1.04). A mechanism of female-specific rescue of translocation trisomy, due to loss of maternal chromosome, resulting in female preponderance among carriers of balanced translocations, along with reciprocal male preponderance among carriers of unbalanced translocations, could explain the observed phenomenon. Both female-biased SR among carriers of balanced 45,der(13;14),upd(14) with 4♂/12♀ and malebiased SR among carriers of unbalanced 46,+13,der(13;14) with 16♂/2♀, support the proposed hypothesis.