World Journal of Pediatrics

, Volume 13, Issue 2, pp 152–157 | Cite as

Comorbidities in Down syndrome livebirths and health care intervention: an initial experience from the birth defects registry in Southern Thailand

  • Somchit Jaruratanasirikul
  • Wannee Limpitikul
  • Pathikan Dissaneevate
  • Paveena Booncharoen
  • Pongsak Tantichantakarun
Original Article

Abstract

Background

Down syndrome (DS) is the most common chromosomal disorder causing mental retardation with a worldwide average prevalence of 1-2 cases per 1000 births. This study aimed to determine the comorbidities associated with DS and the coverage of health care services and developmental interventions for DS livebirths in Southern Thailand.

Methods

A total of 149 livebirth DS infants, recruited through the prospective birth defects registry system during 2009-2013 in 3 provinces in Southern Thailand, were regularly followed-up every 3-6 months. The data collection form included the infants’ demographic data, associated congenital anomalies, and developmental interventions.

Results

The DS infants were born at an average gestational age of 38.5±2.3 weeks with average birth weight of 2760±478 g, length 48.5±2.2 cm, and head circumference 32.7±1.2 cm. Congenital heart diseases, gastrointestinal defects and congenital hypothyroidism were found in 43.0%, 6.7%, and 12.1% of the cases, respectively. The percentage of DS infants who received developmental interventions in this current study were significantly greater than in a previous study covering the years 1992-2002: early stimulation program 90.0% vs. 65.6% (P<0.01), and speech training program 74.8% vs. 38.9% (P<0.01), respectively, and the infants in our study began intervention programs significantly earlier, 0.58±0.39 years vs. 1.69±0.66 years, respectively.

Conclusions

Congenital heart disease was the most common comorbidity associated with DS. The coverage of health care services and developmental interventions for DS children has generally improved in Southern Thailand. One hundred percent coverage of health services and interventions for children with special needs is expected in the near future.

Key words

developmental intervention Down syndrome trisomy 21 

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Notes

Acknowledgements

This research was supported by the Birth Defects Association (Thailand) and the Thai Health Promotion Foundation. The authors gratefully thank the staff of the 467 participating hospitals for their assistance with data collection. The authors thank Mr. David Patterson from the International Affairs Office in the Faculty of Medicine, Prince of Songkla University, for editorial help.

References

  1. 1.
    Rankin J, Pattenden S, Abramsky L, Boyd P, Jordan H, Stone D, et al. Prevalence of congenital anomalies in five British regions, 1991-99. Arch Dis Child Fetal Neonatal Ed 2005;90:F374–F379.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Boyd PA, Khoshnood B, Loane M, Garne E, Dolk H, EUROCAT working group. Survey of prenatal screening in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down’s syndrome. BJOG 2008;115:689–696.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Loane M, Morris JK, Addor M-C, Arriola L, Budd J, Doray B, et al. Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe: impact of maternal age and prenatal screening. Eur J Human Genet 2012;21:27–33.CrossRefGoogle Scholar
  4. 4.
    Jaruratanasirikul S, Soponthammarak S, Chanvitan P, Limprasert P, Sriplung H, Leelasamran W, et al. Clinical abnormalities, intervention program, and school attendance of Down syndrome children in Southern Thailand. J Med Assoc Thai 2004;87:1199–1204.PubMedGoogle Scholar
  5. 5.
    Jaruratanasirikul S, Kor-anantakul O, Chowvichian M, Limpitikul W, Dissaneevate P, Intharasangkanawin N, et al. A populationbased study of prevalence of Down syndrome in Southern Thailand. World J Pediatr 2017;13:63–69.CrossRefPubMedGoogle Scholar
  6. 6.
    Statistical Forecasting Bureau, National Statistical Office, Ministry of Information and Communication Technology, Thailand. Key Statistics of Thailand 2012. http://service.nso. go.th/nso/nsopublish/pubs/pubsfiles/Key55_T.pdf (accessed 14 February 2014).Google Scholar
  7. 7.
    Bull MJ, Committee on Genetics. Health supervision for children with Down syndrome. Pediatrics 2011;128:393–406.CrossRefPubMedGoogle Scholar
  8. 8.
    Nutrition Division, Department of Health, Ministry of Public Health, Thailand. Reference for weight, height and nutritional indices in Thais aged 1 day to 19 years. Bangkok, Thailand. Department of Health, Ministry of Public Health: Bangkok; 2000.Google Scholar
  9. 9.
    Charoensiriwatana W, Janejai N, Boonwanich W, Krasao P, Chaisomchit S, Waiyasilp S. Neonatal screening program in Thailand. Southeast Asian J Trop Med Public Health 2003;34 Suppl 3:94–100.PubMedGoogle Scholar
  10. 10.
    Sutivijit Y, Banpavichit A, Wiwanitkit V. Prevalence of neonatal hypothyroidism and phenylketonuria in Southern Thailand: a 10-year report. Indian J Endocrinol Metab 2011;15:115–117.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Jaruratanasirikul S, Patarakijavanich N, Patanapisarnsak C. The association of congenital hypothyroidism and congenital gastrointestinal anomalies in Down’s syndrome infants. J Pediatr Endocrinol Metab 1998;11:241–246.CrossRefPubMedGoogle Scholar
  12. 12.
    Unachak K, Tanpaiboon P, Pongprot Y, Sittivangkul R, Silvilairat S, Dejkhamron P, et al. Thyroid functions in children with Down’s syndrome. J Med Assoc Thai 2008;91:56–61.PubMedGoogle Scholar
  13. 13.
    Bonnier C. Evaluation of early stimulation programs for enhancing brain development. Acta Paediatr 2008;97:853–858.CrossRefPubMedGoogle Scholar
  14. 14.
    Wasant P, Boonyawat B, Tritilanunt S, Vatanavicharn N, Sathienkijakanchai A, Ratanarak P, et al. Factors influencing development of Down syndrome children in the first three years of life: Siriraj experience. J Med Assoc Thai 2008;91:1030–1037.PubMedGoogle Scholar
  15. 15.
    Hanprasertpong T, Kor-anantakul O, Prasartwanakit V, Leetanaporn R, Suntharasaj T, Suwanrath C. Outcome of second trimester amniocentesis in singleton pregnancy at Songklanagarind Hospital. J Med Assoc Thai 2011;94:1288–1292.PubMedGoogle Scholar
  16. 16.
    Pruksanusak N, Suwanrath C, Kor-anantakul O, Prasartwanakit V, Leetanaporn R, Suntharasaj T, et al. A survey of the knowledge and attitudes of pregnant Thai women towards Down syndrome screening. J Obstet Gynecol Res 2009;35:876–881.CrossRefGoogle Scholar
  17. 17.
    ACOG Committee on Practice Bulletins. ACOG practice bulletin No. 77:screening for fetal chromosomal abnormalities. Obstet Gynecol 2007;109:217–227.CrossRefGoogle Scholar
  18. 18.
    American College of Obstetricians and Gynecologists. ACOG practice bulletin No. 88, December 2007. Invasive prenatal testing for aneuploidy. Obstet Gynecol 2007;110:1459–1466.Google Scholar
  19. 19.
    Kor-anantakul O, Awapark P, Suwanrath C, Suntharasaj T, Hanprasertpong T. The knowledge and attitudes of Thai obstetrics and gynaecology residents towards Down syndrome screening. J Med Assoc Thai 2013;96:7–12.PubMedGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Somchit Jaruratanasirikul
    • 1
  • Wannee Limpitikul
    • 2
  • Pathikan Dissaneevate
    • 3
  • Paveena Booncharoen
    • 4
  • Pongsak Tantichantakarun
    • 5
  1. 1.Department of Pediatrics, Faculty of MedicinePrince of Songkla UniversityHat Yai, SongkhlaThailand
  2. 2.Medical Education CenterSongkhla HospitalSongkhlaThailand
  3. 3.Medical Education CenterHatyai HospitalHat Yai, SongkhlaThailand
  4. 4.Medical Education CenterTrang HospitalTrangThailand
  5. 5.Phatthalung HospitalPhatthalungThailand

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