Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Nov 9, 2021; 10(6): 177-191
Published online Nov 9, 2021. doi: 10.5409/wjcp.v10.i6.177
Prevalence of pulmonary hypertension among children with Down syndrome: A systematic review and meta-analysis
Amar Taksande, Divya Pujari, Patel Zeeshan Jameel, Bharati Taksande, Revat Meshram
Amar Taksande, Divya Pujari, Patel Zeeshan Jameel, Revat Meshram, Department of Pediatrics, Jawaharlal Nehru Medical College, Wardha 442004, Maharashtra, India
Bharati Taksande, Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha 442102, Maharashtra, India
Author contributions: Taksande A contributed to the conception and design of this study; Pujari D, Jameel PZ and Meshram R contributed to the identification of studies and analysis of the data; Taksande B solved disagreements; Taksande B, Taksande A and Meshram R interpreted the data; Pujari D and Jameel PZ drafted the article; Taksande A, Taksande B and Meshram R critically revised the article for important intellectual content; All authors have approved the final version; Taksande A shall act as guarantor of the paper and he/she should take the responsibility for the integrity of the work as a whole, from its inception to published article.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amar Taksande, MBBS, MD, Professor, Department of Pediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha 442004, Maharashtra, India. amar.taksande@gmail.com
Received: January 19, 2021
Peer-review started: January 19, 2021
First decision: May 6, 2021
Revised: May 13, 2021
Accepted: August 17, 2021
Article in press: August 17, 2021
Published online: November 9, 2021
Processing time: 293 Days and 23.7 Hours
ARTICLE HIGHLIGHTS
Research background

Children with Down syndrome (DS) have an increased likelihood of developing pulmonary hypertension (PH) with serious short- and long-term consequences. Approximately 75% of all deaths in DS may be attributed to pneumonia and infectious lung disease, congenital heart disease (CHD) and circulatory disease (vascular diseases such PH). Despite the overwhelming evidence of morbidity, there have been no studies estimating the precise disease burden of PH in children with DS.

Research motivation

Additional information is required to collate the prevalence rates of PH in order to undertake definitive measures for early diagnosis and management.

Research objectives

The objective of this study is to determine the prevalence of PH in children with DS.

Research methods

The electronic databases (PubMed, Cochrane library, EMBASE, Scopus, Web of Science) were searched. Any observational study which determined the prevalence of PH in DS was considered for the analysis. Data were extricated using a preconceived and standardized data abstraction form. The data were analyzed by Comprehensive Meta-Analysis Software Version 2.

Research results

Of 1578 articles identified, 17 were selected for final analysis. The pooled prevalence of PH in these studies was 25.5% (95%CI: 17.4%–35.8%). Subgroup analysis was carried out for age, gender, region, year of publication, risk of bias and etiology of PH.

Research conclusions

This article highlights the increasing prevalence of PH in children with DS. This is accounted for by the high prevalence of underlying CHDs in these children. In order to improve the care given and reduce the disease burden, the attending pediatrician has a crucial role in being aware of this morbid disease and to channel his/her efforts towards routine screening of PH, earlier diagnosis and successful management. In addition, there should be early routine echocardiographic screening in children with DS even in the absence of CHDs. Community-based studies with a larger sample size of children with DS may be carried out to better characterize the epidemiology and underlying etiology of PH in DS. Our study reinforces what is already known and provides, in addition, reliable information about the prevalence of PH in DS.

Research perspectives

Further studies are required to better characterize the epidemiology, underlying etiology, pathogenesis and risk factors of PH in children with DS.