Survival outlook improving for babies with Down syndrome

Early life mortality of children with Down syndrome has been dropping in the past couple of decades, according to a recent Hong Kong study.

Researchers conducted a population-based, retrospective cohort study of 1,010 live births of children with Down syndrome. Their data were extracted from the country’s Clinical Data Analysis and Reporting System of the Hospital Authority. Outcomes included survival rates and the number of attendances to the accident and emergency department.

In the study sample, an average of 8.0 per 10,000 live births were of children with Down syndrome. This decreased over time, dropping from 11.8 per 10,000 live births in 1995 to 3.4 per 10,000 in 2014.

There were 83 deaths during the observation period. The overall 6-month, 1-year and 5-year survival estimates were 95.8 percent, 94.4 percent and 92.6 percent, respectively. Mortality was at its peak during the first 6 months of life.

Neonatal mortality decreased over time. The risk of dying was significantly lower in the 2000–2004 (adjusted hazard ratio [HR], 0.39, 95 percent confidence interval [CI], 0.20–0.76) and 2005–2009 (adjusted HR, 0.54, 95 percent CI, 0.30–0.96) birth cohorts relative to comparators born in 1995–1999.

In contrast, children with low birth weight (adjusted HR, 2.38, 95 percent CI, 1.18–4.83), congenital heart defects (adjusted HR, 1.85, 1.15–2.98) and congenital anomalies of the circulatory system (adjusted HR, 2.24, 95 percent CI, 1.34–3.75) were all significant risk factors for mortality in those with Down syndrome.