Causes of death in individuals with trisomy 18 after the first year of life

Author:

Mehl Justin M.1ORCID,Gelfond Jonathan1,Carey John C.2ORCID,Cody Jannine D.13ORCID

Affiliation:

1. University of Texas Health Science Center San Antonio Texas USA

2. Department of Pediatrics University of Utah Salt Lake City Utah USA

3. The Chromosome 18 Registry and Research Society San Antonio Texas USA

Abstract

AbstractMortality in individuals with trisomy 18 has significantly decreased over the past 20 years, but there is scant literature addressing the prognosis and cause of death in individuals with trisomy 18 and survival past the first year of life (YOL). This study analyzed factors associated with mortality and cause of death in a retrospective cohort of 174 individuals with trisomy 18 and survival past the first YOL, the largest such series to date. Data were collected via retrospective survey of parents of affected individuals. Prenatal diagnosis of trisomy 18; postnatal respiratory distress; maternal age > 35 years; birthweight <2000 g; brain and spinal cord defect(s); atrial and/or ventricular septal defect(s); inability to feed orally without medical assistance; and failure to meet sitting and rolling milestones were associated with mortality in this sample. Cause of death was compared between our cohort of individuals with trisomy 18 and existing literature on those with mortality before the first YOL. Individuals with trisomy 18 with mortality after the first YOL demonstrated a predominance of infectious (n = 10/22) and postoperative (n = 6/22) contributing causes of death, in contrast to the existing literature, which shows a predominance of cardiopulmonary causes of death (e.g., cardiopulmonary arrest, pulmonary hypertension). These findings demonstrate that individuals with trisomy 18 and survival past the first YOL have unique medical needs, but further research is needed to develop clinical guidelines for this growing population.

Funder

Chromosome 18 Registry & Research Society

Publisher

Wiley

Subject

Genetics (clinical),Genetics

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