Occurrence of Congenital Heart Disease among Children with Down syndrome: What is the Influence of Maternal Age?

Abstract

Background: The occurrence of Down syndrome is strongly dependent on maternal age and incidence varies at various maternal ages. This incidence may differ from one country to another according to the social and environmental factors predominant in such countries. The study aims to document the prevalence of congenital heart defects in patients with Down syndrome, identify the association between maternal age and occurrence of congenital heart disease among these subjects

Methods: The study was prospective, cross-sectional and consecutive, involving subjects from two centers which were; a tertiary hospital, a private hospital which is a major cardiology center. Children with clinical features of Down syndrome had transthoracic echocardiography done by a cardiologist.

Results: A total of 195 patients with Down syndrome were studied ages between1day to 12years. The mean age + SD were 241.03 + 529.71days and male to female ratio of 1.04:1. The mother’s age range was from 19 to 44years with a mean age + SD of 32.36 + 5.43 years. Up to 16.9% had structurally normal heart. The most common heart defect was atrioventricular septal defect 24.1%. There was no significant association between maternal age and occurrence of congenital heart defects in the subjects.

Conclusion: The incidence of congenital heart disease is high among subjects with Down syndrome. Atrioventricular defects were the commonest cardiac defect among the subjects. The incidence of congenital heart defect in the subjects was decreasing from maternal age 36 years and above. Routine cardiac evaluation including echocardiography is recommended for all patients with Down syndrome.