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Survival Analysis of Down Syndrome Cohort in a Tertiary Health Care Center in India

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Abstract

Objective

To identify the major causes of death in Down Syndrome (DS), the ages at which mortality rates are the highest and recognize factors associated with it.

Methods

The prospective cohort-based study was carried out in a tertiary health care center. Children with DS (n = 543) counseled at the Center of Medical Genetics, Sir Ganga Ram Hospital from 2005 through 2009 were followed up in year 2010. Survival curves and Cox’s proportional hazards regression analysis were used to determine the effect of different variables on survival.

Results

Total mortality was 13 %, of which 80.3 % was in children less than 2 y of age. Presence of congenital heart disease (CHD) increased the risk of mortality by 5.7 folds (p = 0.001). A definitive survival benefit after cardiac intervention was noted, although it differed with the type of CHD. Sex, maternal age at time of birth and karyotypes did not show a significant correlation with survival.

Conclusions

The higher DS infant mortality observed in the present study could be attributed to financial constraints of the families and misconceptions amongst health professionals. It is recommended that a nation-wide DS registry be created to study the morbidity and mortality in Down syndrome from birth. The findings of this study will help clinicians in making management decisions and enable better counseling.

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Acknowledgements

The authors would like to thank Ashish Upadhyay for his assistance with statistical analysis.

Conflict of Interest

None.

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Authors and Affiliations

  1. Center of Medical Genetics, Sir Ganga Ram Hospital, Rajinder Nagar, 110060, New Delhi, India

    Risha Nahar, Udhaya Kotecha, Ratna Dua Puri & Ishwar Chander Verma

  2. Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Ravindra Mohan Pandey

Authors
  1. Risha Nahar
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  2. Udhaya Kotecha
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  3. Ratna Dua Puri
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  4. Ravindra Mohan Pandey
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  5. Ishwar Chander Verma
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Corresponding author

Correspondence to Ishwar Chander Verma.

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Nahar, R., Kotecha, U., Puri, R.D. et al. Survival Analysis of Down Syndrome Cohort in a Tertiary Health Care Center in India. Indian J Pediatr 80, 118–123 (2013). https://doi.org/10.1007/s12098-012-0836-3

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  • DOI: https://doi.org/10.1007/s12098-012-0836-3

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