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[Rising infant mortality in down syndrome in Chile from 1997 to 2013]
Enrique Donoso1, Claudio Vera1
1División de Obstetricia y Ginecología, Unidad de Medicina Basada en la Evidencia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Background:
Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations.
Aim:
To describe the trend in Chilean infant mortality in DS in the period 1997-2013 as compared to the general population without DS.
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.
Results:
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).
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.