Abstract
BackgroundThe association between maternal age and risk of Down syndrome has been repeatedly shown in various populations. However, the effect of paternal age and education of parents has not been frequently studied. Comparative studies on Down syndrome are also rare. This study evaluates the epidemiological characteristics of Down syndrome in two culturally and socially contrasting population settings, in California and the Czech Republic.MethodsThe observed live birth prevalence of Down syndrome was studied among all newborns in the California counties monitored by California Birth Defects Monitoring Program from 1996 to 1997, and in the whole Czech Republic from 1994 to 1998. Logistic regression was used to analyze the data.ResultsA total of 516,745 (California) and 475,834 (the Czech Republic) infants were included in the analysis. Among them, 593 and 251, respectively, had Down syndrome. The mean maternal age of children with Down syndrome was 32.1 years in California and 26.9 years in the Czech Republic. Children born to older mothers were at greater risk of Down syndrome in both populations. The association with paternal age was mostly explained by adjusting for maternal age, but remained significant in the Czech Republic. The association between maternal education and Down syndrome was much stronger in California than in the Czech Republic but parental age influences higher occurrence of Down syndrome both in California and in the Czech Republic.ConclusionThe educational gradient in California might reflect selective impact of prenatal diagnosis, elective termination, and acceptance of prenatal diagnostic measures in Californian population.
Highlights
The association between maternal age and risk of Down syndrome has been repeatedly shown in various populations
There is a large difference in proportion of Down syndrome babies born to younger women (< 35 years); in California it was 59.5% and in the Czech Republic 87.3% of Down syndrome babies
The association between maternal education and Down syndrome was much stronger in California than in the Czech Republic
Summary
The association between maternal age and risk of Down syndrome has been repeatedly shown in various populations. The effect of paternal age and education of parents has not been frequently studied. Comparative studies on Down syndrome are rare. This study evaluates the epidemiological characteristics of Down syndrome in two culturally and socially contrasting population settings, in California and the Czech Republic. The disease is associated with mental retardation, immune system disorders, autoimmune problems, premature aging and Alzheimer disease at the age of 30–40 years [1,2]. The association between maternal age and risk of having a Down syndrome pregnancy was first published in 1933 [3]. In 1959 the presence of an extra chromosome 21 was identified [4]. In 1966, the first chromosome analysis of amniotic fluid cells was published [5]. The first report of the antenatal (page number not for citation purposes)
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