Management and outcomes of neonates with down syndrome admitted to neonatal units.
BACKGROUND
Neonates with Down syndrome have an increased risk of being admitted to a neonatal unit compared with unaffected neonates. We aimed to estimate the proportion of neonates with Down syndrome admitted to a neonatal unit and compare their management and outcomes with other neonatal admissions.


METHODS
Case-control study of neonates born from 2009 to 2011 admitted to 122 NHS Neonatal Units in England using data from the National Down Syndrome Cytogenetic Register and the National Neonatal Research Database. For each neonate with Down syndrome, three neonates admitted to the same unit in the same month and born at the same gestation were identified.


RESULTS
Forty-six percent of neonates with Down syndrome were admitted to a neonatal unit. Boys were more likely to be admitted than girls (odds ratio = 1.7; 95% confidence interval, 1.4-2.0). Neonates with Down syndrome required more intensive or high dependency care compared with unaffected neonates (37% vs. 27%. p < 0.01) and stayed in neonatal units for longer (11 days vs. 5 days, p < 0.01). A total of 31% of neonates with Down syndrome required respiratory support compared with 22% (p < 0.001) of unaffected neonates, and 11% were discharged requiring oxygen supplementation compared with 3% (p < 0.001) of unaffected neonates. A total of 3% of neonates with Down syndrome died in a neonatal unit compared with 1% (p = 0.01) of unaffected neonates.


CONCLUSIONS
Neonates with Down syndrome are more likely than unaffected neonates to be admitted to a neonatal unit, have a prolonged stay, and be discharged home on supplemental oxygen. Birth Defects Research (Part A) 106:468-474, 2016. © 2016 Wiley Periodicals, Inc.
Department of paediatrics, University of Cambridge, Cambridge, United Kingdom.
Jake P
JP
Mann
Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, United Kingdom.
Eugene
E
Statnikov
Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, United Kingdom.
Neena
N
Modi
Children's unit, Hinchingbrooke Hospital, Huntingdon, United Kingdom.
Nik
N
Johnson
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.
Anna
A
Springett
Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom.
Joan K
JK
Morris
D003422:Critical Care; D016208:Databases, Factual; D004314:Down Syndrome / Q000453:epidemiology* / Q000628:therapy*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011181:Postnatal Care; D012189:Retrospective Studies
Down syndrome; Trisomy 21; neonatal care; perinatal outcomes