Early mortality and morbidity in children with Down's syndrome diagnosed in two regional health authorities in 1989.

OBJECTIVES - To assess the risk of early mortality and the quality of health of a recent cohort of 5 year old children with Down's syndrome to provide current information on prognosis. SETTING - A follow up study in 1994 of all live births with a cytogenetic diagnosis of trisomy 21 or related karyotype born in 1989 and diagnosed in the South East Thames and Oxford Regional Health Authorities; these amounted to 100 children. RESULTS - Eighteen of the sample of 100 had died in the first three years, and seven were reported as adopted. Fifty six mothers were interviewed, including five of children who had died. High rates of associated congenital defects were reported. The most common were congenital heart defects, which were reported for 29 of the 69 children for whom health information was available, and were certified as the underlying cause of death of 12 and required surgery in 11. At least five children had had gastrointestinal atresia or other gut blockage, most presenting at birth but one case occurring at 3 years, and these had necessitated a colostomy in two cases. Leukaemia had occurred in two children, both of whom had died. As expected mothers also reported high rates of defects of hearing, often treated with grommets; of vision; and frequent severe infections. CONCLUSIONS - Information of this nature, as well as that regarding the more positive aspects of Down's syndrome, should be made available to those counselling parents considering the offer of diagnostic tests.