International Journal of Epidemiology, Vol 28, 711-716, Copyright © 1999 by International Epidemiological Association
KK Naguib, SA Al-Awadi, MA Moussa, L Bastaki, S Gouda, MA Redha, F Mustafa, SM Tayel, SA Abulhassan and DS Murthy
BACKGROUND: Trisomy 18 (Edwards' syndrome, T18) is the second most common
trisomy in man. We describe 118 children with regular T18 who were
ascertained clinically and cytogenetically in the Kuwait Medical Genetics
Centre during 1980-1997. METHODS: Ascertainment of T18 cases was performed
shortly after birth. Chromosomal studies were carried out in addition to
other relevant investigations. To investigate the factors associated with
T18, a case-control study was carried out with 131 normal healthy newborns.
Studied factors included maternal and paternal age, birth order, abortion,
associated malformation, and survival. Multiple logistic regression
analysis was used to adjust for confounding between variables. RESULTS:
There was a preponderance of females among T18 cases (female:male ratio
2.1:1). The majority of T18 cases (53%) died before the second week of
life. The most common associated anomalies were: congenital heart (38.1%)
and gastrointestinal (25.4%). Multiplicity of malformations was also
observed. Significant seasonal variation in T18 cases was detected with a
peak in spring. Of the 118 T18 cases, 59 were delivered during 1994- 1997
(average overall T18 birth prevalence rate 8.95 per 10 000 live births [95%
CI: 6.66-11.23]). Concerning maternal age, 30.5% of the T18 cases' mothers
were > or =35 years compared to 10.7% in the control group. The
difference was statistically significant, P = 0.002. Logistic regression
analysis showed that maternal age >30 years was a significant risk
factor for T18, after adjusting for confounding with paternal age. Paternal
age and abortion were not found to be significant risk factors. CONCLUSION:
Trisomy 18 birth prevalence rate is high in Kuwait with advanced maternal
age as a significant risk factor.
ARTICLES
Trisomy 18 in Kuwait
Kuwait Medical Genetic Centre.
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