Delayed Motherhood Increases the Risk of Down syndrome: Metropolis Study

October - Down syndrome Awareness Month 

Down syndrome is a genetic disorder that causes mental retardation and abnormal physical growth. Down syndrome occurs when an individual has a full or partial extra copy of chromosome 21 (trisomy 21).  

Down syndrome increases risk for certain medical conditions such as congenital heart defects, respiratory, hearing problems, childhood leukemia, and thyroid conditions. It affects about 1 in 800 babies worldwide and in India every year more than 23,000 babies are born with Down syndrome.

October is observed as Down syndrome Awareness Month globally.  In order to understand the intensity of the chromosomal disorder in India, Metropolis Healthcare Ltd, the Pathology Specialist, conducted a comprehensive study on 38,081 prenatal screening samples processed in 2014.  

Prenatal screening is necessary to reveal disorder or conditions that affect the fetus and help improve outcome of pregnancy. 

There are two types of prenatal screening that are available; Noninvasive Methods like Ultrasonography and Biochemical test like Dual marker test in the first trimester (8 to 13.6 weeks gestation age), Triple marker test in the second trimester (14 to 22.6 weeks),and Quadruple marker test in the third trimester (14 to 22.6 weeks gestation age). The other type of screening is Invasive procedures like Amniocentesis and Chorionic villous sampling.

In prenatal Biochemical markers screening of over 38,081 samples, 6.13% of the total samples were at the risk of Down syndrome. That is over 2334 samples were found positive for Downs Syndrome Risk. 

The increasing trend of late marriages and delayed first pregnancy that usually occurs between the age group of 31-35 years increases the risk of having a baby born with the syndrome.  

Trisomy 21 Screening by Biochemical markers Test ( 1 year data)

		Age group (years)
Test Type	Biochemical trisomy 21 statistical risk	20	21-25	26-30	31-35	35-40	40	Total pregnant Women
Dual  Marker	Screen NEGATIVE (low risk)	378	2917	5726	3310	791	43	13165
	Screen POSITIVE (High risk)	12	132	312	397	263	52	1168
DM Result		390	3049	6038	3707	1054	95	14333
Triple Marker	Screen NEGATIVE  (low risk)	518	3708	6645	4078	1026	36	16011
	Screen POSITIVE (High risk)	4	42	159	252	298	83	838
TM Result		522	3750	6804	4330	1324	119	16849
Quadruple marker	Screen NEGATIVE  (low risk)	129	1248	2825	1821	523	25	6571
	Screen POSITIVE (High risk)	3	26	77	107	95	20	328
QM  Result		132	1274	2902	1928	618	45	6899
Total Result		1044	8073	15744	9965	2996	259	38081

The study reveals a worrying trend in the age group of 31-35 years. Out of 9965 samples studied, 7.78% denotes the risk of Down’s syndrome pregnancies. Highest number of Screened positive cases for Down's syndrome was found in the age group of 35-40 years; out of 2996 samples studied, 21.89% of the results were screened positive. 

The ACOG (American College of Obstetrician and Gynecologist) guideline 2007 recommends that every woman regardless of Age needs to be screened for Downs Syndrome.

All the screened positive (High risk) cases by the statistical calculation needs to be confirmed by Invasive procedures like Amniocentesis in Second trimester and Chorionic Villous sampling in first trimester.

Adding on the study Dr. Deepak Sanghavi, HOD Clinical Chemistry and Accession, Metropolis Healthcare Ltd, Mumbai said, “Down’s syndrome is a genetic condition where the child has an extra copy of the 21st chromosome. 

With the increase in the maternal age, the likelihood of having a child affected with Down’s syndrome increases considerably. A woman who is 40 years old at the time of conceiving a child is at a 16 times greater risk of giving birth to a baby affected with Down’s syndrome, as compared to a woman who conceives at the age of 25.”  

ABOUT METROPOLIS HEALTHCARE LTD.

 At Metropolis, what we believe is what we say and what we say is what we do. Being empathetic to our customers and being committed to their needs is in our DNA. Metropolis has grown to harness a culture that is open, synergistic, progressive and scientific in nature.

 We are the Pathology Specialists delivering over 15 million tests a year, catering to more than 10,000 Laboratories, Hospitals, Nursing homes and 2,00,000 Consultants. With 33 years of experience in delivering accurate reports, Metropolis has earned the reputation of being India's most respected and only multinational chain of diagnostic centres with presence in UAE, Sri Lanka, South Africa, Kenya, Mauritius and Ghana.

Driven to make a difference, our wide network includes 125 state-of-art Laboratories across India with over 750 collection centres, processing over 4500 varieties of tests and supported by an efficient team of more than 3000 people. Equipped with cutting edge technology, innovative work equipment, expansive logistics network and rigorous processes, Metropolis ensures and delivers precision and accuracy in every single test; each time, every time.

In the last 10 years, Metropolis has expanded into new service lines like Clinical Trials, Hospital Lab Management, Home Health Services, Preventive Health Check-ups and Corporate & Wellness Solutions. Metropolis is at the forefront in adopting cutting edge technologies and services that contribute new revenue streams and has positioned the company on the pedestal it is today.

 Today, we are one of the few laboratories that has received the CAP (College of American Pathologists), accreditation, the global gold standard in Laboratory Accreditation. 12 of our laboratories in India has received the NABL Accreditation (National Accreditation Board for testing and Calibration Laboratories). In addition, the central laboratory in Mumbai also adheres to CLIA (Clinical Laboratory Improvement Amendments) program and also follows the guidelines laid by GCP and GLP. Our unit in South Africa is accredited by SANAS (South African National Accreditation System is the only accreditation body approved by South African Government).

Metropolis has been awarded numerous accolades like the ‘Best Diagnostic Company of the year’ by Modern Medicare in 2006 and ‘Best Diagnostic Company of the Year’ in 2010 by Frost & Sullivan. Metropolis was also bestowed with ‘Best IT Integration in Customer Service Management’ at the e-Health World Expo 2011. Metropolis was also honoured with the ‘Quality Brand Award’ by NEHRDO in 2012. Metropolis won the ‘CMO Asia Award’ for Best IT practices in Healthcare in 2012.

 Metropolis Healthcare is led by Ameera Shah, Managing Director & CEO. An International & National Award winners, she was conferred with ‘The Young entrepreneur of the Year Award’ by GE in 2006 and ‘The Young Achiever of the Year Award’ at the CMO Asia Awards in 2011. 

She was also the recipient of the prestigious ‘Young Entrepreneur of the Year Award’ in 2011 organised by Entrepreneur India and Bloomberg. She has been honoured with ‘Women Leadership award’ at the World Women Leadership and Congress awards 2014.  Recently she has been chosen as one of the most respected leaders under 40 years by Economic Times & Spencer Stuart (2014).

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