Gestational age-based outcomes of neonates with Down syndrome in the neonatal intensive care unit (NICU): review of pediatric health information system (PHIS) database

Objective To examine differences in neonatal intensive care unit (NICU) outcomes in neonates with Down syndrome (DS) by gestational age (GA) using a large national database Study design Retrospective analysis of Pediatric Health Information System database, including neonates with DS admitted to the NICU <30 days old from 1/1/2008-12/31/2022. Neonates were stratified by GA (extremely preterm, very preterm, moderate/late preterm, term). GA-based risk differences were examined for NICU outcomes using term neonates as reference. Results Overall mortality rate was 7% with increasing mortality as GA decreased (RD 6.1 [95% CI 4.8, 7.5], RD 25.4 [95% CI 20.5, 30.6], RD 36.8 [95% CI 27.3, 46.8] for moderate/late preterm, very preterm, extremely preterm). The overall rate of pulmonary hypertension was 23% and 14% of the cohort required a gastrostomy tube. Conclusion Prematurity significantly increases risk of NICU mortality for neonates with DS. Rates of pulmonary hypertension and gastrostomy were high throughout all groups.