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The impact of trisomy 21 on epidemiology, management and outcomes of congenital duodenal obstruction - a population based study

The impact of trisomy 21 on epidemiology, management and outcomes of congenital duodenal obstruction - a population based study
The impact of trisomy 21 on epidemiology, management and outcomes of congenital duodenal obstruction - a population based study
Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down's syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23-41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21.
0179-0358
477–483
Bethell, George S.
9c442b15-1e62-4b7a-8334-85024c37ecc2
Long, Anna-May
cb5ff398-cbcd-4a87-b9bd-8f53b9fd0dd9
Knight, Marian
7cfa08c5-3235-4c6c-b5f9-aa784379d4e0
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf
Bethell, George S.
9c442b15-1e62-4b7a-8334-85024c37ecc2
Long, Anna-May
cb5ff398-cbcd-4a87-b9bd-8f53b9fd0dd9
Knight, Marian
7cfa08c5-3235-4c6c-b5f9-aa784379d4e0
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf

Bethell, George S., Long, Anna-May, Knight, Marian and Hall, Nigel (2020) The impact of trisomy 21 on epidemiology, management and outcomes of congenital duodenal obstruction - a population based study. Pediatric Surgery International, 477–483. (doi:10.1007/s00383-020-04628-w).

Record type: Article

Abstract

Purpose: Congenital duodenal obstruction (CDO) is associated with trisomy 21 (T21), or Down's syndrome, in around a third of infants. The aim of this study was to explore the impact of T21 on the epidemiology, management, and outcomes of infants with CDO. Methods: Data were prospectively collected from specialist neonatal surgical centres in the United Kingdom over a 12 month period from March 2016 using established population-based methodology for all babies with CDO. Infants with T21 were compared to those without any chromosomal anomaly. Results: Of 102 infants with CDO that underwent operative repair, T21 was present in 33 [32% (95% CI 23-41%)] babies. Cardiac anomalies were more common in those with T21 compared to those without a chromosomal anomaly (91 vs 17%, p < 0.001), whereas associated gastrointestinal anomalies were less common in infants with T21 (3 vs 12%, p = 0.03). Surgical management was not influenced by T21. Time to achieve full enteral feed, need for repeat related surgery, and mortality were similar between groups. Infants with T21 had a longer median initial inpatient stay (23 vs 16.5 days, p = 0.02). Conclusions: Infants with T21 have a higher incidence of cardiac anomalies and a longer initial inpatient stay; however, it does not change CDO management or outcomes. This information is important for prenatal and postnatal counselling of parents of infants with CDO and T21.

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Accepted/In Press date: 8 February 2020
e-pub ahead of print date: 29 February 2020

Identifiers

Local EPrints ID: 437964
URI: http://eprints.soton.ac.uk/id/eprint/437964
ISSN: 0179-0358
PURE UUID: 34e70fd5-89a4-4d88-8dc7-e9e47ea7fd57
ORCID for Nigel Hall: ORCID iD orcid.org/0000-0001-8570-9374

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Date deposited: 24 Feb 2020 17:31
Last modified: 28 Apr 2022 02:04

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Contributors

Author: George S. Bethell
Author: Anna-May Long
Author: Marian Knight
Author: Nigel Hall ORCID iD

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