Down Sendromlu Çocuklarda Tıbbi Komorbiditelerin Nörogelişimsel Özellikler Üzerine Etkisi

Abstract

Amaç: Down Sendromu (DS), 21. kromozomun fazlalığı (trizomi 21) sonucu ortaya çıkan, yaklaşık 700 canlı doğumdan birinde görülen en yaygın genetik anomalilerden biridir. DS'lu çocuklarda bilişsel gelişim genellikle orta ila şiddetli gerilik aralığındadır ve zihinsel yaş nadiren sekiz yaşın üzerindedir. Bu çalışmanın amacı, 1-6 yaş arası DS'lu çocukların nörogelişimsel özelliklerini ve eşlik eden tıbbi patolojiler ile ilişkisini araştırmaktır. Gereç ve Yöntem: Çocuk ve ergen ruh sağlığı polikliniğine başvuran toplam 83 DS'lu çocuk çalışmaya dahil edilerek sosyodemografik ve tıbbi öykü ile nörogelişimsel özellikler arasındaki ilişkiler incelenmiştir. Gelişimlerini değerlendirmek için Denver II Gelişimsel Tarama Testi kullanıldı. Dört alan değerlendirildi: kaba motor gelişim, ince motor gelişim, dil-bilişsel gelişim ve kişisel-sosyal gelişim. Bulgular: DS'li çocuklarda tıbbi ek hastalık oranları %75.9'du (38'inde kalp sorunu, 17'sinde tiroid disfonksiyonu ve 8'inde epilepsi vardı). Denver II Gelişimsel Tarama Testi puanları açısından cinsiyetler arasında istatistiksel olarak anlamlı fark yoktu. Hipotiroidili çocuklar, tüm alanlarda önemli ölçüde daha düşük Denver II Gelişimsel Tarama Testi puanlarına sahiptir. Diğer tıbbi komorbiditelerin Denver II Gelişimsel Tarama Testi puanları üzerinde anlamlı bir etkisi olmamıştır. Sonuç: DS'lu çocuklarda eşlik eden tıbbi hastalıklar çocuğun gelişimini etkileyebilir. Bu nedenle, bu durumların erken teşhisi ve tedavisi önemlidir. Hipotiroidinin çocukların gelişimine olumsuz etkileri nedeniyle bu çocukların tedavi ve yakın takibinde dikkatli olunmalıdır.

Keywords

• Down Sendromu
• nörogelişim
• tıbbi komorbidite

The Effects of Medical Comorbidities on Neurodevelopmental Features in Children with Down Syndrome

Abstract

Background: Down Syndrome (DS) is one of the most common genetic anomalies observed in approximately one out of 700 live births, which occurs as a result of an excess of chromosome 21 (trisomy 21). Cognitive development in DS children is generally in the range of moderate to severe retardation, and mental age is rarely above eight years. The aim of this study is to investigate the neurodevelopmental characteristics of children with DS between the ages of 1-6 and their relationship with comorbid medical pathologies. Materials and Methods: A total of 83 DS children who applied to the child and adolescent mental health outpatient unit, were included in the study, and the relationships between sociodemographic and medical histories and neurodevelopmental characteristics were analyzed. Denver II Developmental Screening Test was used to evaluate their development. Four areas were evaluated: gross motor development, fine motor development, language-cognitive development and personal-social development. Results: The rates of medical comorbidities in children with DS was 75.9% (38 had heart problems, 17 had thyroid dysfunction, and 8 had epilepsy). There was no statistically significant difference between genders in terms of Denver II Developmental Screening Test scores. Children with hypothyroidism have significantly lower Denver II Developmental Screening Test scores in all domains. Other medical comorbidities did not have a significant effect on Denver II Developmental Screening Test scores. Conclusions: Concomitant medical diseases in children with DS may affect the development of the child. Therefore, early diagnosis and treatment of these conditions is essential. Due to the negative effects of hypothyroidism on the development of children, care should be taken in the treatment and close follow-up of these children.

Keywords

• Down Syndrome
• neurodevelopment
• medical comorbidity

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