Audit of Adherence to Best Practice Guidelines for Children born with Down Syndrome.

Abstract

Aims: The aim of this audit is to determine adherence to the Down Syndrome Medical Interest Group (DSMIG) Neonatal Best Practice Guideline in a tertiary neonatal unit over a 5-year period. Our secondary objective was to describe patterns in the demographics, admissions and clinical course.

Methods: This is a retrospective audit of infants with a diagnosis of DS between 2018 and 2022 in Cork University Maternity Hospital (CUMH). Ethical approval was obtained prior to data collection. Demographics and clinical data were obtained from the electronic health records (EHR). Data was collated and analysed using a password encrypted Microsoft excel dataset. Continuous data was reported as mean or median. Categorical data was outlined as counts. Dichotomous variables were summarised as proportions. A Chi Squared Test and Fishers exact test were used to assess dichotomous variables.

Results: 73 patients were included in this audit of which 37 (51%) were female. The median gestation was 38 and 3 days and median birthweight was 3100g. 60 (82.2%) required admission to NICU with 43 (58.3%) admitted immediately after birth. Median hospital stay was 10 days. 8 (11%) had growth parameters documented during their admission. 66 (90%) of patients had an ECHO performed (63 (95.4%) abnormal). 19 (26%) were exclusively breastfeeding and 7 (9.7%) required feeding support on discharge. All babies underwent screening for haematological and thyroid abnormalities, but 13 (18%) babies had unnecessary bloods taken for serum TFT levels. Referrals were made for audiology (60, 82.2%), ophthalmology (17, 23.3%) and other relevant healthcare professionals.

Discussion: This audit shows good adherence to the DSMIG guideline in areas of cardiovascular and haematological monitoring but indicates a need for improvement in other categories.