Improved Survival in Down Syndrome over the Last 60 Years and the Impact of Perinatal Factors in Recent Decades

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• 作者：Emma J. Glasson ; PhD ; ^{Emma.Glasson@telethonkids.org.au" class="auth_mail" title="E-mail the corresponding author} ; Angela Jacques ; MBiostat ; Kingsley Wong ; MPH ; Jenny Bourke ; MPH ; Helen Leonard ; MBChB
• 关键词：CVD ; Cardiovascular defect ; DSC ; Disability Services Commission ; HR ; Hazard ratio ; IDEA ; Intellectual Disability Exploring Answers ; SEIFA ; Socioeconomic Indexes for Areas ; t0 ; Time of observation ; WA ; Western Australian ; WARDA ; WA Register for Developmental Anomalies
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：169
• 期：Complete
• 页码：214-220.e1
• 全文大小：680 K

文摘

To calculate the survival of people with Down syndrome over the past 60 years and the influence of major perinatal factors by using linked population-based data.

Study design

A data linkage between 2 Western Australian (WA) data sets (the Register for Developmental Anomalies and the Intellectual Disability Exploring Answers database) was used to identify 772 children born with Down syndrome in WA from 1980-2010. Perinatal and mortality data were extracted from the WA Midwives Information System and WA death registrations and compared with the remaining WA population born during that same era. An additional 606 children with Down syndrome living in WA prior to 1980 were available from a disability services database and were used for predicting survival into adulthood.

Results

Overall, for cases born 1953-2010, 88% (95% CI 86%, 90%) survived to 5 years of age, 87% (95% CI 85%, 89%) to 10 years, and 83% (95% CI 80%, 85%) to 30 years. Children live-born with Down syndrome were significantly more likely (all P > .001) to have mothers older than 35 years (32.7% vs 13.4%), a gestational age less than 37 weeks (23.8% vs 7.9%), a cesarean delivery (28.9% vs 23.0%), and a birth weight less than 2500 g (20.4% vs 6.1%). Down syndrome survival was reduced in the presence of a cardiovascular defect, younger gestational age, low birth weight, or earlier birth years.

Conclusions

Improved survival for children born with Down syndrome over the last 60 years has occurred incrementally, but disparities still exist for children who are preterm or have low birth weight.