EPIDEMIOLOGY OF DOWNS-SYNDROME IN A SCOTTISH CITY
EPIDEMIOLOGY OF DOWNS-SYNDROME IN A SCOTTISH CITY
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DOI：
10.1111/j.1365-3016.1995.tb00149.x
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发表时间：
1995-07-01
影响因子：
2.8
通讯作者：
GILMOUR, H
中科院分区：
文献类型：
--
作者：
LOPEZ, PM;STONE, D;GILMOUR, H
这项研究的目的是调查唐氏综合征（DS）的流行病学方面的人口进行连续监测。数据来自格拉斯哥先天性畸形登记处。在1980- 1990年期间，确定了173例DS（每1000例分娩1.2例），其中135例（78.1%）为活产，5例（2.9%）为死产，33例（19.1%）为产前诊断后终止妊娠。尽管大多数DS妊娠发生在35岁以下的女性中，但随着产妇年龄的增加，DS的风险增加得到证实。虽然DS的出生患病率随时间变化不显著，但DS妊娠患病率显著增加。在引入了一种新的DS风险筛查标志物后，所有DS妊娠终止的比例从1980-87年的14%上升到1988-90年的31%，具有统计学意义。在35岁及以上的女性中，近一半的DS妊娠在产前诊断后终止，而35岁以下的女性只有7%。在城市较繁华的地区，DS妊娠的风险在统计学上显着增加;这种增加持续存在，但在对产妇年龄进行标准化后，没有统计学意义。这些研究结果表明，根据流行病学趋势，没有减少为DS儿童提供服务的余地，产前筛查计划虽然受益于最近引入的血清风险标志物，但仍然对老年妇女产生更大的影响，并且需要使用基于人口的登记处进行进一步的病原学研究。
The aim of the study was to investigate aspects of the epidemiology of Down's syndrome (DS) in a population subjected to continuous surveillance. Data were obtained from the Glasgow Register of Congenital Anomalies. Over the period 1980-90, 173 cases of DS were identified (1.2 per 1000 births), of which 135 (78.1%) were livebirths, five (2.9%) were stillbirths and 33 (19.1%) were terminations following prenatal diagnosis. The increasing risk of DS with advancing maternal age was confirmed, although most DS pregnancies occurred in women aged under 35. While the birth prevalence of DS did not vary significantly over time, there was a significant increase in DS pregnancy prevalence. The proportion of all DS pregnancies terminated showed a statistically significant rise from 14% in 1980-87 to 31% in 1988-90 following the introduction of a new screening marker for DS risk. Almost half of DS pregnancies in women aged 35 and over ended in termination following prenatal diagnosis compared with only 7% in women under 35. There was a statistically significant excess risk of DS pregnancy in the more prosperous areas of the city; this excess persisted, but was not statistically significant, after standardising the rates for maternal age. These findings suggest that there is no scope for reducing service provision for DS children on the basis of the epidemiological trends, that the antenatal screening programme, while benefiting from the recent introduction of serum markers of risk, continues to have a greater impact on older women, and that further aetiological research using population based registries is required.