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Down syndrome

Última revisão das evidências: 26 Sep 2026
Última atualização do tópico: 23 Oct 2026

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
Full details

Other diagnostic factors

  • congenital gastrointestinal disorder
  • constipation
  • feeding difficulty
  • behavioral difficulties
Full details

Risk factors

  • advanced maternal age
  • previous child with Down syndrome
  • parental karyotype with a translocation
Full details

Diagnostic investigations

1st investigations to order

  • chromosomal karyotype
  • CBC with differential
  • echocardiogram
  • hearing test
  • thyroid function tests
  • vision exam
Full details

Tests to avoid

  • routine celiac screen
  • routine cervical spine x-ray
Full details

Investigations to consider

  • abdominal x-ray
Full details

Treatment algorithm

ACUTE

newborns

ONGOING

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
  • Down syndrome images
  • Differentials

    • Isolated hypotonia
    • Zellweger syndrome
    • Congenital hypothyroidism
    More Differentials
  • Guidelines

    • Screening for fetal chromosomal abnormalities
    • Health supervision for children and adolescents with Down syndrome
    More Guidelines
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