Prevalence of down syndrome among children and adolescents in metropolitan Atlanta

BACKGROUND: Down syndrome (DS) prevalence estimates beyond infancy are needed to assess health service needs among those with DS. METHODS: Children with DS born in metropolitan Atlanta from 1979 through 2003 were ascertained from a population-based birth defects registry. Vital status through 2003 was obtained using case records, vital records, and the National Death Index. Prevalence was calculated by dividing the children surviving with DS by the population derived from U.S. Census estimates. Variations in DS prevalence by race, heart defects, age, birth cohort, and time period were examined using Poisson regression. RESULTS: In metropolitan Atlanta in 2003, there were 67 livebirths with DS (13.0 per 10,000 livebirths) and 738 0- to 19-year-olds surviving with DS (8.3 per 10,000 population). Over time, births to mothers 35 years and older and DS birth prevalence increased. Birth prevalence was higher among Whites, did not vary by sex, and was higher for infants without heart defects. DS prevalence among 0- to 14-year-olds increased over time (p < .05). Within each 5 year birth cohort, prevalence decreased with age: this decrease was greater among Blacks than among Whites and among children with heart defects than among children without heart defects. CONCLUSIONS: DS prevalence increased among livebirths and among young children. Further studies are warranted to determine whether health services are meeting the needs of an increasing number of children with DS.