To the Editor.—
Using data from metropolitan Atlanta, Adams et al (1981; 246:758) have reported a decrease in the crude incidence of Down's syndrome from 1.33/1,000 births in 1960 to approximately 0.99/1,000 births in 1978. According to the authors, the explanation for this decrease is a reduction in the proportion of births to women aged 35 years or older. They suggest that estimates of resources for future services should be based on these data.We have been able to ascertain all cytogenetically proved cases of Down's syndrome live births in Rhode Island during 1976 to 1980. Since Rhode Island has only two cytogenetic laboratories where blood specimens for chromosomal analysis are routinely sent and one child development center where most children with Down's syndrome are followed up, we are confident that the ascertainment of all live-born children with Down's syndrome is as complete as can be achieved anywhere. Our demographic
Barsel-Bowers G, Abuelo DN, Pueschel SM. Incidence of Down's Syndrome in Rhode Island. JAMA. 1982;248(6):645. doi:10.1001/jama.1982.03330060013009
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