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Down syndrome

Last reviewed: 25 Nov 2025
Last updated: 24 Jan 2025

Summary

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 tests

1st tests 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

Tests 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.

Disclosures

JV declared that she had no competing interests.

Peer reviewers

Nirupama S. Madduri, MD

Assistant Professor

Developmental-Behavioral Pediatrics

Vanderbilt University School of Medicine

Nashville

TN

利益声明

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

利益声明

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.

参考文献

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.

关键文献

Bull MJ, Trotter T, Santoro SL, et al. Health supervision for children and adolescents with Down syndrome. Pediatrics. 2022 May 1;149(5):e2022057010.全文

American College of Obstetricians and Gynecologists. Screening for fetal chromosomal abnormalities: ACOG Practice Bulletin summary, number 226. Obstet Gynecol. 2020 Oct;136(4):859-67.全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Down syndrome images
  • 鉴别诊断

    • Isolated hypotonia
    • Zellweger syndrome
    • Congenital hypothyroidism
    更多 鉴别诊断
  • 指南

    • Health supervision for children and adolescents with Down syndrome
    • Guidelines on thyroid disorder in children and young people with Down syndrome: surveillance and when to initiate treatment
    更多 指南
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