Hospitalizations of infants and young children with Down syndrome: evidence from inpatient person-records from a statewide administrative database.
Half of kids with Down syndrome are hospitalized before age three—mostly for breathing problems—and heart defects double that risk.
01Research in Context
What this study did
Fullana et al. (2007) looked at every hospital bill for kids with Down syndrome in one U.S. state. They counted how many babies and toddlers went to the hospital before their third birthday. They also noted who had heart defects and why each child was admitted.
What they found
Half of the children were admitted at least once before age three. Kids with congenital heart disease landed in the hospital twice as often and much earlier. Most stays were for breathing problems like colds that turned serious.
How this fits with other research
The numbers line up with Ghaziuddin et al. (1996), a review that already warned Down syndrome carries high odds of heart, thyroid, and lung trouble.
Tenenbaum et al. (2012) later showed the same breathing-and-heart pattern continues in adults, proving the risk never goes away.
Hickey et al. (2025) tracked over 2,300 families and found 80% of babies needed a NICU stay—higher than the 50% admission rate seen here. The gap makes sense: Francis counted NICU only, while A et al. counted any hospital ward, so the two studies complement rather than clash.
Why it matters
For BCBAs, early illness means missed therapy days and weaker learning momentum. Build infection-control habits now: ask parents about cardiac status, push for flu shots, and program hand-washing as a daily target. When a child with CHD starts coughing, coordinate with the nurse early—you may prevent a week-long hospital gap that erases hard-won skills.
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02At a glance
03Original abstract
BACKGROUND: Although individuals with Down syndrome are increasingly living into the adult years, infants and young children with the syndrome continue to be at increased risk for health problems. Using linked, statewide administrative hospital discharge records of all infants with Down syndrome born over a 3-year period, this study 'follows forward' over 200 infants with Down syndrome from each individual's birth until they turn 3 years of age. By utilizing this procedure, we were able to assess the amount, reasons for, and timing of inpatient hospitalization and to investigate how congenital heart defects (CHDs) relate to hospitalization for young children with Down syndrome. METHOD: This population-based, retrospective study used statewide administrative hospital discharge data. Subject inclusion criteria included residents of Tennessee, born between 1997 and 1999, and diagnosed with Down syndrome at birth. Inpatient records were linked to create person-record histories of hospitalization from birth to age 3. Main outcomes included the number of Non-birth Hospitalizations, length of stay, principal and other diagnosis codes to indicate reason(s) for hospitalization, and patient's age at first (non-birth) hospitalization. Procedure codes were added to determine if children with CHD were hospitalized primarily for operations on the heart. RESULTS: Of 217 births, 213 children survived birth; 54% (115) had CHDs. Almost half (49.8%) of all children were hospitalized before age 3; these 106 children were admitted 245 times. Children with CHDs were 2.31 times more likely to be hospitalized than children without CHDs. Respiratory illnesses affected 64.9% of all hospitalized children with CHD, were the principal diagnoses in 38.3% of their hospitalizations, and were the main principal diagnoses for non-CHD children. Thirty-three (of 77) hospitalized children with CHD underwent cardiac surgeries, accounting for 19.3% of all admissions. Median time to first hospitalization was 96 days (CI: 78-114) for CHD infants, 197 days (CI: 46-347) for non-CHD infants. CONCLUSIONS: Children with Down syndrome are at high risk for early hospitalization. Prevention and treatment of respiratory illnesses require more attention. Down syndrome is associated with early, serious, physical health problems and substantial inpatient care use.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2007.01013.x