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Recent trends in the prevalence and secondary prevention of Down's syndrome
D H Stone1, K Rosenberg, J Womersley
1Social Paediatric and Obstetric Research Unit, University of Glasgow, UK.
Insights
Most Down's syndrome births occurred in mothers under 35, despite the known link between maternal age and prevalence. Continued monitoring and improved screening are needed for Down's syndrome pregnancies.
Area of Science:
- Epidemiology
- Medical Genetics
- Public Health
Background:
- Down's syndrome (DS) prevalence and risk factors require ongoing study.
- Maternal age is a known risk factor for Down's syndrome.
- Understanding prevalence patterns is crucial for public health interventions.
Purpose of the Study:
- To analyze Down's syndrome birth prevalence in Greater Glasgow (1974-1986).
- To investigate the relationship between maternal age and Down's syndrome incidence.
- To assess trends in prevalence and the impact of antenatal diagnosis.
Main Methods:
- Retrospective analysis of birth data from the Glasgow Registry of Congenital Anomalies.
- Calculation of period prevalence for Down's syndrome.
- Correlation analysis between maternal age and Down's syndrome occurrence.
Main Results:
- A period prevalence of 1.1 per 1000 total births was observed.
- Most Down's syndrome infants were born to mothers under 35, despite a positive correlation with maternal age.
- No significant decline in annual prevalence or change in maternal age risk pattern was detected.
- Antenatal diagnosis led to termination in less than 10% of Down's syndrome pregnancies.
Conclusions:
- Further etiological research into Down's syndrome is warranted.
- Continued epidemiological monitoring of Down's syndrome is essential.
- Improved uptake of amniocentesis by older mothers and development of universal screening tests are recommended.
Abstract:
Examination of data from the Glasgow Registry of Congenital Anomalies indicated that 184 infants with Down's syndrome were born (live or still) to mothers residing in the Greater Glasgow Health Board area between 1974 and 1986 inclusive. This represents a period prevalence of 1.1 per 1000 total births. Despite a strongly positive correlation between prevalence and maternal age, most of the Down's syndrome infants were born to mothers aged under 35 years. There was no evidence either of a recent decline in the annual prevalence rate or of a changing pattern of risk in relation to maternal age. Antenatal diagnosis resulted in the termination of less than a tenth of all Down's syndrome pregnancies. These findings point to a need for further aetiological research, for continued epidemiological monitoring, for an improvement in the relatively low uptake of amniocentesis by older mothers, and for the development of a screening test which can be offered to the entire pregnant population.