Patterns of cardiac care in infants with Down syndrome
D. S. Schneider, K. G. Zahka, E. B. Clark and C. A. Neill
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore.
To determine if the pattern of cardiac care is affected by the presence of
Down syndrome (DS) we analyzed the records of infants enrolled in the
Baltimore-Washington Infant Study, a regional case-control study of
congenital cardiovascular malformations. The age at cardiac diagnosis, the
timing of cardiac surgery, and the one-year outcome were compared in 160
infants with DS and 540 infants with the same cardiac diagnoses but without
chromosomal or other extracardiac anomalies (Isolated cardiovascular
malformation [ICM] group). Cardiac referral and diagnosis were accomplished
by 13 weeks of age in 78% of infants with DS and 67% of those with ICMs.
However, by 26 weeks of age, the proportion of infants in both groups was
comparable. Cardiac surgery was performed before 1 year of age in 99 of 160
infants with DS and in 141 of 540 infants with ICMs. The surgical outcome
was similar in the two groups. We conclude that for defects of comparable
severity, the pattern of cardiac care in the Baltimore-Washington, DC, area
for infants with DS is timely and comparable to care for infants with ICMs.
