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Trends in Down syndrome births in the U S from 1989 to 1998 An analysis by maternal age



Trends in Down syndrome births in the U S from 1989 to 1998 An analysis by maternal age



American Journal of Obstetrics & Gynecology 184(1): S54, January



OBJECTIVE: Advanced maternal age (gtoreq35 years old) is a risk factor for fetal aneuploidy. We sought to investigate trends in Down syndrome (DS) live births in the US from 1989 to 1998 in 14- to 34-year-old women (<35) and 35- to 49-year-olds (AMA). STUDY DESIGN: Using data from the National Center for Health Statistics, the number of maternal age-specific live births were recorded for each calendar year from 1989 to 1998 and stratified into live births to women <35 and AMA. Age-specific maternal live births were multiplied by the age-specific DS risk (Bray, I et al, Pren Diag; 1998) to estimate the number, by year of maternal age, of DS cases (Est DS) from 1989 to 1998 assuming no antenatal intervention. Birth certificate reports of live births of Down syndrome (Rep DS) infants to women < 35 and AMA were also recorded by year from 1989 to 1998. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for the two age groups comparing each year to 1989. RESULTS: The number of Rep DS decreased although the Est DS increased from 1989 to 1998. For all ages the OR of Rep DS to Est DS live births decreased 40% from 1989 to 1998. This trend was greater in women < 35 where the OR decreased 42% compared to 24% in AMA women. CONCLUSION: Assuming that there has been no temporal change in the birth certificate reporting of DS, prenatal screening, diagnosis, and intervention have resulted in a 40% decrease in the number of DS live births in the US despite a trend toward delayed childbearing.

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