Association of Maternal Age with Type of Congenital Heart Disease in Patients with Down Syndrome: A Single-center Study

Abstract

Background: Congenital heart disease (CHD) is commonly seen in patients with Down syndrome (DS) and is closely associated with morbidity and mortality. Maternal age is an established risk factor for DS. Objectives: The aim of the present study is to analyze the incidence of CHD in Down syndrome and the effect of maternal age on this incidence and the type of CHD. Materials and Methods: Six hundred and thirty-one patients with DS who were admitted to pediatric cardiology department, between December 2014 and December 2018, were retrospectively analyzed. The detected CHDs were evaluated in association with maternal age. Results: Four hundred forty-five (70.5%) cases had one or more congenital heart defect. Two hundred and seven patients (32.8%) had isolated simple defect while the remaining had complex or associated multiple CHDs (n:238, 37.7%). Considering all patients, secundum ASD (42.1%) was the most frequent CHD followed by PDA (33.9%), VSD (28.6%) and AVSD (9.6%).  Regarding the maternal age, the incidence of CHD was lowest in babies whose maternal age were between 25-35 years. AVSD, was most frequent in patients born to mothers aging ≤20 years. Incidence of ASD did not markedly differ between maternal age groups while nearly half of the patients born to mothers aging between 21-25 years had PDA and incidence of VSD was markedly increased with the maternal age of >45 years. Conclusion: Distribution of CHD also varies in accordance with maternal age. Babies born to mothers aged <25 or >35 years are more likely to have CHD. Incidence of AVSD, which had been reported to be the most common CHD in patients with DS, has been decreased in time and tends to be mostly associated with maternal age of ≤20 years.