Document Detail


Trends and geographic inequalities in the prevalence of Down syndrome in Europe, 1980-1999.
MedLine Citation:
PMID:  16471148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: EUROCAT is a network of population-based registries for the epidemiologic surveillance of congenital anomalies covering approximately one quarter of births in the European Union. Down syndrome constitutes approximately 8% of cases of registered congenital anomaly in Europe, with over 7000 affected pregnancies in the 15 current member states of the European Union each year. In this paper, we aim to examine trends in the live birth prevalence of Down syndrome in Europe in the light of trends in maternal age and in prenatal diagnosis. METHODS: Descriptive analysis of data from 24 EUROCAT registries, covering 8.3 million births 1980-99. Cases include live births, stillbirths and terminations of pregnancy following prenatal diagnosis. RESULTS: Since 1980, the proportion of births to mothers of 35 years of age and over has risen quite dramatically from 8 to 14% for the European Union as a whole, with steeper rises in some regions. By 1995-1999, the proportion of "older" mothers varied between regions from 10% to 25%, and the total prevalence (including terminations of pregnancy) of Down syndrome varied from 1 to 3 per 1000 births. Some European regions have shown a more than twofold increase in total prevalence of Down syndrome since 1980. The proportion of cases of Down syndrome which were prenatally diagnosed followed by termination of pregnancy in 1995-1999 varied from 0% in the three regions of Ireland and Malta where termination of pregnancy is illegal, to less than 50% in 14 further regions, to 77% in Paris. The extent to which terminations of pregnancy were concen trated among older mothers varied between regions. The live birth prevalence has since 1980 increasingly diverged from the rising total prevalence, in some areas remaining approximately stable, in others decreasing over time. CONCLUSION: The rise in average maternal age in Europe has brought with it an increase in the number of pregnancies affected by Down syndrome. The widespread practice of prenatal screening and termination of pregnancy has in most of the regions covered by EUROCAT counteracted the effect of maternal age in its effect on live birth prevalence. Under the joint influences of maternal age and prenatal screening the pattern of geographic inequalities in Down syndrome live birth prevalence in Europe has also been changed.
Authors:
H Dolk; M Loane; E Garne; H De Walle; A Queisser-Luft; C De Vigan; M C Addor; B Gener; M Haeusler; H Jordan; D Tucker; C Stoll; M Feijoo; D Lillis; F Bianchi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revue d'épidémiologie et de santé publique     Volume:  53 Spec No 2     ISSN:  0398-7620     ISO Abbreviation:  Rev Epidemiol Sante Publique     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-02-13     Completed Date:  2006-03-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7608039     Medline TA:  Rev Epidemiol Sante Publique     Country:  France    
Other Details:
Languages:  eng     Pagination:  2S87-95     Citation Subset:  IM    
Affiliation:
EUROCAT Central Registry, Room 15E12, Faculty of Life and Health Sciences, University of Ulster at Jordanstown, Shore Rd, Newtownabbey BT37 OQB, Ulster, UK. h.dolk@ulster.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Down Syndrome / epidemiology*
Europe / epidemiology
Female
Humans
Maternal Age
Prevalence
Registries

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