Global Prevalence of Duodenal Atresia in Trisomy 21: A Systematic Review and Meta-Analysis.

Abstract

Introduction:  Duodenal atresia is one of significant causes of neonatal intestinal obstruction. It often co-occurs with Down syndrome. This study is conducted to estimate the global prevalence of duodenal atresia in Down syndrome patients and to investigate associated factors.

Methods:  Conducting a systematic review with meta-analysis of 18 eligible studies reporting duodenal atresia prevalence in pediatric Down syndrome patients. Study quality is assessed using the Newcastle-Ottawa Scale. The subgroup analysis on region, study quality, publication year, and design is addressed. Gender-specific prevalence rates are examined.

Results:  The pooled prevalence of duodenal atresia in Down syndrome is 3.0%, with significant heterogeneity. The Middle East reports a higher prevalence of 6.0%, while Latin America, India, and Canada exhibit a lower prevalence of 1.0%. High-quality studies demonstrate 2% prevalence, while moderate-quality studies report 4.0%. Gender analysis indicates a similar incidence for females and males at 3.0%. Prevalence varies with study design: case-control studies report 4.0%, cross-sectional studies report 2.0%, and prospective cohort studies report 2.0%.

Conclusions:  Duodenal atresia is common in Down syndrome patients, affecting 3.0% of the patients worldwide. Regional variations exist, necessitating further investigation. Gender does not significantly impact prevalence. This study highlights the need for region-specific research to enhance clinical decision-making for individuals with Down syndrome and duodenal atresia.