Indicators of Growth, Nutritional Status and Comorbide Disorders of Newborns With Down Syndrome
Condition: Down Syndrome,Auxological Indexes, Auxological Parametars, Intrauterine Growth Restriction
MeSH terms: Down Syndrome; Fetal Growth Retardation; Syndrome
Study type: Observational

Summary: 
      Objective To access predictive values of the auxological parameters and indexes for risk of
      comorbid malformations in newborns with Down syndrome (DS)

      Study design In this cohort retrospective study, 141 newborns with proven trisomy 21 born at
      the Department of Gynecology and Obstetrics of the University of Split Hospital (1990 to
      2015) were included. The data were obtained from the medical histories of mothers, infants
      and the delivery protocol.

      The objective was to access predictive values of the auxological parameters and indexes for
      risk of comorbid malformations in newborns with Down syndrome (DS)

      Conclusion Higher CI were found in hyportrophic (SGA) newborns with DS and indicated their
      intrauterine growth restriction with brain sparing and increased further risk of severe
      psychomotor retardation. The SGA newborns have lower parameters and indexes of nutritive
      status and significantly differed from eutrophic and hypertrophic newborns. These SGA
      newborns with DS have increased developmental risks and that requires further diagnostic
      attention.
    

Detailed description: 
      Use of anthropometric charts developed specifically for children with DS have a better
      expression of real growth restriction (small for gestation age/SGA, 9.9%) than the
      application of the percentile curve for typical children (SGA, 24.1%). These differences were
      also noted in the evaluation of other anthropometric measures. Cephalization index (CI)
      proved to be the only predictor from the considered auxological parameters and indexes with
      minimal predictive value in the prediction of heart defects type ASD II and VSD.

      The presence of comorbid disorders in newborns with DS did not have a significant predictive
      role on growth indicators and nutritive status of the newborn, but we noted a strong
      association between preterm births and white matter injury (WMI).
    

Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The perinatal outcome of 141 children with confirmed diagnosis of DS was evaluated
        retrospectively. 137 (137/141, 97.2%) children had the cytogenetic finding of regular
        trisomy 21, 3 (3/141, 2.1%) had the kariotypic finding of mosaicism and 1 child (1/ 141. %)
        had translocation 21/22.

        There were more boys (74/141, 52.5%) than girls (67/141, 47.5%) in the examined sample.

        The median of gestational age of newborns with DS was 38 weeks (range 37-38 weeks): 10
        children were born at 40 weeks of gestation (7.1%), 34 at 38 weeks (24.1%), 24 at 37 weeks
        (16.3%), 15 children (10.6%) at 36 weeks; and 19 children from 32 to 35 weeks of gestation.

        The median of gravidity for boys was the 3rd pregnancy, and for girls the 2nd pregnancy.
        The age range of the mother for both sexes was 31 to 35 years.
      
Keywords: growth restriction, nutritive status, comorbide disorders, Down Syndrome