Incidence of Newborns with Down Syndrome and Factors Associated with Their Length of Hospital Stay in Hospital Pakar Universiti Sains Malaysia
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Abstract
Background: Down syndrome (DS) is the most common chromosomal disorder worldwide. This study aimed to analyse the incidence of newborns with DS in a tertiary centre in the East Coast of Peninsular Malaysia and determine the factors associated with the length of hospital stay among them.
Methods: This is a retrospective study from 2017 to 2021 that recruited 41 newborns with DS. We analysed patients’ clinical characteristics, comorbidities and length of hospital stay. Kaplan-Meier survival and Cox regression analyses were used to determine the median length of hospital stay and factors affecting the length of hospital stay.
Results: The incidences of newborns with DS for five consecutive years were between 0.52 and 1.39 in 1,000 live births. The gender was equally distributed and the majority were delivered from advanced maternal age with multiple antenatal histories. The majority had non-disjunction trisomy 21 and were born with multiple comorbidities. Median length of hospital stay (IQR) among newborns with DS is 24 days (17.7–30.3). Every newborn with pulmonary hypertension (adjusted hazard ratio [aHR]: 0.24; 95% CI 0.10, 0.58), feeding intolerance (aHR: 0.16, [95% CI 0.06, 0.54]) and who had been invasively ventilated (aHR: 0.13, [95% CI 0.03, 0.48]) is expected to have a prolonged hospital stay.
Conclusion: The incidence of newborns with DS in Hospital Pakar Universiti Sains Malaysia is lower than other countries worldwide. We found that pulmonary hypertension, history of invasive ventilation and feeding intolerance are the main factors that affect the length of hospital stay for newborns with DS in our hospital.
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References
Chen L, Wang L, Wang Y, Hu H, Zhan Y, Zeng Z, et al. Global, regional, and national burden and trends of Down syndrome from 1990 to 2019. Front Genet. 2022;13:908482. https://doi.org/10.3389/fgene.2022.908482
Weijerman ME, van Furth AM, Vonk Noordegraaf A, van Wouwe JP, Broers CJM, Gemke RJBJ. Prevalence, neonatal characteristics, and first-year mortality of Down syndrome: a national study. J Pediatr. 2008;152(1):15–19. https://doi.org/10.1016/j.jpeds.2007.09.045
Martin T, Smith A, Breatnach CR, Kent E, Shanahan I, Boyle M, et al. Infants born with Down syndrome: burden of disease in the early neonatal period. J Pediatr. 2018;193:21–26. https://doi.org/10.1016/j.jpeds.2017.09.046
Kadakol GS, Bagoji I, Patil SV, Bulagouda RS. Cytogenetic analysis of Down syndrome. Int J Clin Biomed Res. 2019;5(1):10. https://doi.org/10.31878/ijcbr.2018.51.10
Hoe TS, Boo NY, Clyde MM. Incidence of Down’s syndrome in a large Malaysian maternity hospital over an 18-month period. Singapore Med J. 1989;30:246–248.
Seither K, Tabbah S, Tadesse DG, Suhrie KR. Neonatal complications of Down syndrome and factors necessitating intensive care. Am J Med Genet A. 2021;185(2):336–343. https://doi.org/10.1002/ajmg.a.61948
Hopper RK, Abman SH, Elia EG, Avitabile CM, Yung D, Mullen MP, et al. Pulmonary hypertension in children with Down syndrome: results from the Pediatric Pulmonary Hypertension Network Registry. J Pediatr. 2023;252:131–140.e3. https://doi.org/10.1016/j.jpeds.2022.08.027
Zahari N, Mat Bah MN, Razak HA, Thong MK. Ten-year trend in prevalence and outcome of Down syndrome with congenital heart disease in a middle-income country. Eur J Pediatr. 2019;178(8):1267–1274. https://doi.org/10.1007/s00431-019-03403-x
Brochard L. Mechanical ventilation: invasive versus noninvasive. Eur Respir J Suppl. 2003;20(47):30s–46s. https://doi.org/10.1183/09031936.03.00050403
Goussard P, Rhode D, Gie A, Janson J. Diagnosis of congenital airway abnormalities in children. Pediatr Respir J. 2023;1(3):105–119. https://doi.org/10.56164/PediatrRespirJ.2023.15
Fanaro S. Feeding intolerance in the preterm infant. Early Hum Dev. 2013;89(Suppl 2):S13–S20. https://doi.org/10.1016/j.earlhumdev.2013.07.013
Mann JP, Statnikov E, Modi N, Johnson N, Springett A, Morris JK. Management and outcomes of neonates with Down syndrome admitted to neonatal units. Birth Defects Res. 2016;106(6):468–474. https://doi.org/10.1002/bdra.23513
Stanley MA, Shepherd N, Duvall N, Jenkinson SB, Jalou HE, Givan DC, et al. Clinical identification of feeding and swallowing disorders in 0–6 month old infants with Down syndrome. Am J Med Genet A. 2019;179(2):177–182. https://doi.org/10.1002/ajmg.a.11
Smith MD, Landman MP. Feeding outcomes in neonates with trisomy 21 and duodenal atresia. J Surg Res. 2019;244:91–95. https://doi.org/10.1016/j.jss.2019.06.030