Resumo
Definition
History and exam
Key diagnostic factors
- common physical exam features
- hypotonia
- congenital heart disease
- gross motor delay
- language delay
- cognitive disability
- hearing loss
- autism spectrum disorder
Other diagnostic factors
- congenital gastrointestinal disorder
- constipation
- feeding difficulty
- behavioral difficulties
Risk factors
- advanced maternal age
- previous child with Down syndrome
- parental karyotype with a translocation
Diagnostic investigations
1st investigations to order
- chromosomal karyotype
- CBC with differential
- echocardiogram
- hearing test
- thyroid function tests
- vision exam
Tests to avoid
- routine celiac screen
- routine cervical spine x-ray
Investigations to consider
- abdominal x-ray
Treatment algorithm
newborns
children
Contributors
Authors
Kishore Vellody, MD
Professor of Pediatrics
Medical Director
Down Syndrome Center of Western Pennsylvania
UPMC Children’s Hospital of Pittsburgh
Pittsburgh, PA
Disclosures
KV declares that he has no competing interests.
Acknowledgements
Dr Kishore Vellody would like to gratefully acknowledge Dr Jeannie Visootsak, the previous contributor to this topic.
Раскрытие информации
JV declared that she had no competing interests.
Рецензенты
Nirupama S. Madduri, MD
Assistant Professor
Developmental-Behavioral Pediatrics
Vanderbilt University School of Medicine
Nashville, TN
Раскрытие информации
Not disclosed.
W. Carl Cooley, MD
Medical Director
Crotched Mountain Foundation
Medical Director
Center for Medical Home Improvement
Adjunct Professor of Pediatrics
Dartmouth Medical School
Greenfield, NH
Disclosures
WCC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Bull MJ, Trotter T, Santoro SL, et al. Health supervision for children and adolescents with Down syndrome. Pediatrics. 2022 May 1;149(5):e2022057010.Full text
American College of Obstetricians and Gynecologists. Screening for fetal chromosomal abnormalities. Jan 2026 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials
- Isolated hypotonia
- Zellweger syndrome
- Congenital hypothyroidism
More DifferentialsGuidelines
- Screening for fetal chromosomal abnormalities
- Health supervision for children and adolescents with Down syndrome
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