Rising infant mortality in down syndrome in Chile from 1997 to 2013

Enrique Donoso,Claudio Vera

doi:10.4067/s0034-98872016001100009

Enrique Donoso, Claudio Vera

Open Access

https://doi.org/10.4067/s0034-98872016001100009

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Abstract

Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations. To describe the trend in Chilean infant mortality in DS in the period 1997-2013 as compared to the general population without DS. Raw data on infant deaths were extracted from the yearbooks of vital statistics of the National Institute of Statistics. The mortality risk associated to DS, relative to population without DS was estimated. There were 456 deaths in infants with DS during the study period (59 early neonatal deaths, 70 late neonatal deaths and 327 post-neonatal deaths). The trend in infant mortality rate in DS was ascending (r: 0.53, p = 0.03), with an average annual percentage change of 4.6% (95% confidence interval (CI) 0.4-9.0%; p < 0.01). Compared to the population without DS, the risk of early neonatal death was lower in DS (Odds ratio (OR) 0.14, 95% CI 0.11-0.19; p < 0.01) whereas the risk of post-neonatal death was higher (OR 4.74, 95% CI 3.85-5.85; p < 0.01). Infant mortality in Down syndrome has an increasing trend. We postulate that these children are not accessing timely cardiac surgery, the main therapeutic tool to reduce the death risk in the first year of life.

Highlights

Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations
Material and Methods: Raw data on infant deaths were extracted from the yearbooks of vital statistics of the National Institute of Statistics
The mortality risk associated to DS, relative to population without DS was estimated

Summary

Background

Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations. Conclusions: Infant mortality in Down syndrome has an increasing trend We postulate that these children are not accessing timely cardiac surgery, the main therapeutic tool to reduce the death risk in the first year of life. En Chile se observa un cambio demográfico importante, caracterizado por un aumento de los nacimientos en mujeres 40 o más años[10] y un envejecimiento de las mujeres chilenas en edad fértil[11], que las expone a un mayor riesgo de malformaciones congénitas y de hijos con síndrome de Down. El objetivo de este estudio es analizar en Chile las muertes durante el primer año de vida de niños con SD, como también sus componentes neonatales precoz, neonatal tardío y pos neonatal, comparadas con la población general no SD, en el período 1997-2013

Material y Métodos

Neonatal tardía

Findings

Conclusión