This study adhered to guidelines set by the Institutional Review Boards at the participating laboratories. CMA was performed in a subset of clinical ISCA laboratories on cases referred for diagnostic testing with various indications, including: unexplained developmental delay (DD), intellectual disability (ID), dysmorphic features, multiple congenital anomalies (MCA), autism spectrum disorders (ASD) or clinical features suggestive of a chromosomal syndrome. Anonymized data from 15,749 cases were included.