title: Neonatal characteristics and perinatal complications in neonates with Down syndrome.
abstract: The annual rate of Down syndrome (DS) births in Jerusalem is stable, regardless of prenatal screening, and diagnostic measures. We aimed to evaluate our historical cohort for obstetrical characteristics and the neonatal course and complications. We reviewed computerized medical files of neonates with the diagnosis of DS born in the four main hospitals in Jerusalem between the years 2000 and 2010 and evaluated for maternal history and primary neonatal hospitalization. A total of 403 neonates were diagnosed with DS. The average maternal age was 35.6 years, 73% were born via spontaneous vaginal delivery. In all gestational ages, the mean birth weight and head circumference percentiles were significantly lower than the general population (P < 0.001 for both) and at each week the HC percentile was lower than the weight percentile (P < 0.0001), worse among males. Mortality during the primary hospitalization was 3.7%. The most common anomalies were cardiac (79%) with either congenital defects or functional abnormalities, neither influenced the length of hospitalization. The main reasons for prolonged hospitalization were prematurity and anomalies of other (non-cardiac) organs. Common perinatal complications included respiratory failure or need for oxygen supplementation (32%), hyperbilirubinemia (23%), sepsis (6.4%), and feeding difficulties (13%). About 84% were fed by human milk; of those, two thirds were exclusively breast-fed and one third were supplemented with infant formula. In conclusion, infants with DS were small for gestational age with relatively reduced head circumference. Despite the increased rate of congenital anomalies and perinatal complications, most infants were discharged home in good medical condition and were exclusively breastfed.
authors.affiliation: Neonatology Department Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Zivanit
authors.initials: Z
authors.lastname: Ergaz-Shaltiel
authors.affiliation: Down Syndrome Center, Hadassah Medical Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
authors.forename: Offra
authors.initials: O
authors.lastname: Engel
authors.affiliation: Neonatology Department Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Ira
authors.initials: I
authors.lastname: Erlichman
authors.affiliation: Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Naveh
authors.affiliation: Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schimmel
authors.affiliation: Down Syndrome Center, Hadassah Medical Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Tenenbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001942:Breast Feeding; D036861:Delivery, Obstetric; D004314:Down Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011296:Prenatal Diagnosis
keywords: Down syndrome; neonate; perinatal complications