title: Improved Survival in Down Syndrome over the Last 60 Years and the Impact of Perinatal Factors in Recent Decades.
abstract: OBJECTIVE
  To calculate the survival of people with Down syndrome over the past 60 years and the influence of major perinatal factors by using linked population-based data.
  
  
  METHODS
  A data linkage between 2 Western Australian (WA) data sets (the Register for Developmental Anomalies and the Intellectual Disability Exploring Answers database) was used to identify 772 children born with Down syndrome in WA from 1980-2010. Perinatal and mortality data were extracted from the WA Midwives Information System and WA death registrations and compared with the remaining WA population born during that same era. An additional 606 children with Down syndrome living in WA prior to 1980 were available from a disability services database and were used for predicting survival into adulthood.
  
  
  RESULTS
  Overall, for cases born 1953-2010, 88% (95% CI 86%, 90%) survived to 5 years of age, 87% (95% CI 85%, 89%) to 10 years, and 83% (95% CI 80%, 85%) to 30 years. Children live-born with Down syndrome were significantly more likely (all P > .001) to have mothers older than 35 years (32.7% vs 13.4%), a gestational age less than 37 weeks (23.8% vs 7.9%), a cesarean delivery (28.9% vs 23.0%), and a birth weight less than 2500 g (20.4% vs 6.1%). Down syndrome survival was reduced in the presence of a cardiovascular defect, younger gestational age, low birth weight, or earlier birth years.
  
  
  CONCLUSIONS
  Improved survival for children born with Down syndrome over the last 60 years has occurred incrementally, but disparities still exist for children who are preterm or have low birth weight.
authors.affiliation: Telethon Kids Institute, The University of Western Australia, West Perth, Western Australia, Australia. Electronic address: Emma.Glasson@telethonkids.org.au.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Glasson
authors.affiliation: Telethon Kids Institute, The University of Western Australia, West Perth, Western Australia, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Jacques
authors.affiliation: Telethon Kids Institute, The University of Western Australia, West Perth, Western Australia, Australia.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Wong
authors.affiliation: Telethon Kids Institute, The University of Western Australia, West Perth, Western Australia, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Bourke
authors.affiliation: Telethon Kids Institute, The University of Western Australia, West Perth, Western Australia, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Leonard
mesh_terms: D004314:Down Syndrome / Q000401:mortality*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007234:Infant, Premature; D008297:Male; D015996:Survival Rate; D013997:Time Factors