title: Co-morbidities leading to mortality or hospitalization in children with Down syndrome and its effect on the quality of life of their parents.
abstract: OBJECTIVE
  To study factors leading to mortality or hospitalization in children with Down syndrome and its effect on the quality of life of their parents.
  
  
  METHODS
  The study was retrospective questionnaire based study conducted over 2 mo period at a genetic outpatient setting of a teaching medical college hospital. Seventy children with suggestive phenotype and confirmed Trisomy 21 on karyotyping were included. An essential criterion was a reasonable understanding of the language to construct history. The primary outcome variable evaluated was the co-morbidity in these children which led to either hospitalization or mortality. Pretested and validated questionnaire was given to parents/primary caregiver and data was constructed with help of previous hospital records or from verbal autopsy in patients who had lost all papers.
  
  
  RESULTS
  The mean age of Down syndrome (DS) patients in study group was 5.09 ± 2.5 y. All cases were diagnosed postnatally at a mean age of 5 y. The major reasons for hospitalization were congenital heart disease (cyanotic/acyanotic), multiple episodes of pneumonia and wheeze associated with lower respiratory infection. Cardiovascular failure was the major reason for mortality. Majority of parents in the study (57.5 %) agreed that there were changes requiring adaptation after the birth of a DS baby while 22.5 % reported this effort to cost them heavily and 3 % quoted that this had changed the life drastically.
  
  
  CONCLUSIONS
  Cardiorespiratory system is major cause of morbidity/mortality in cases with DS. Majority of parents accepted the challenge of rearing a DS child but with adaptation.
authors.affiliation: Department of Pediatrics, Maulana Azad Medical College, New Delhi, 110002, India, drseemakapoor@gmail.com.
authors.forename: Seema
authors.initials: S
authors.lastname: Kapoor
authors.forename: Swati
authors.initials: S
authors.lastname: Bhayana
authors.forename: Ankur
authors.initials: A
authors.lastname: Singh
authors.forename: Jugal
authors.initials: J
authors.lastname: Kishore
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004314:Down Syndrome / Q000401:mortality* / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires