Co-Occurring Medical Conditions in Over 2300 Children With Down Syndrome at a Down Syndrome Multispecialty Clinic.

Background: Children with Down syndrome (DS) have an increased frequency of co-occurring medical complications compared to the typically developing population; however, incidence rates of co-occurring medical conditions in a large paediatric population-based study are limited. The goal of this study was to further investigate the frequencies of concomitant medical conditions, as well as newborn complications in children with DS.

Methods: This is a retrospective, large cohort review of children with DS (n = 2321) receiving care at a referral centre specialising in DS to identify common patterns of co-occurring conditions in children and young adults with DS. Participants from birth to 24 years of age received care from the Anna and John J. Sie Center for Down Syndrome at Children's Hopsital Colorado, which serves 88% of the State of Colorado's paediatric population with DS. Records reviewed included demographics, birth history, and medical conditions of each patient.

Results: Neonatal complications requiring admission to the neonatal intensive care unit (NICU) were present in 80.0% of the population. Complications leading to these admissions include oxygen requirement (53.7%), feeding problems (49.7%), respiratory distress syndrome (14.7%), and persistent pulmonary hypertension of the newborn (12.6%). Incidence of medical complications for children and young adults with DS includes obstructive sleep apnea (56.8%), cardiac defect requiring surgical repair (48.9%), feeding problems (42.3%), and dysphagia (26.2%). Recently identified co-occurring conditions lacking in the literature, such as keratoconus (3.6%) and Wolff-Parkinson-White syndrome (3.4%), are also reported. Testing, labs and procedures were also common amongst children to meet American Academy of Pediatrics (AAP) DS Guidelines.

Conclusion: Children with DS have unique phenotypic clinical patterns of co-occurring conditions and medical complications. Some conditions present clinically in the neonatal period and require close monitoring and anticipation for a higher level of care for newborns with DS. Our results, using a large sample of over 2300 patients, provide information to improve evidence-based early identification and timely intervention for children and young adults with DS.