Down's syndrome: the effects of prenatal diagnosis and demographic factors in a region of the eastern part of Germany.

The epidemiological analysis of trisomy 21 presented for the new federal German state of Saxony-Anhalt describes trends and changes in the frequency of Down's syndrome and prevalences of the pregnancy outcomes including acceptance of prenatal diagnostic measures in the period from 1980 and with separate analysis for the period since reunification in 1990. The average prevalence in the entire period is 1.0 per 1000 births. In 1997, a prevalence of 1.7 per 1000 births was already observed. After 1990, there is an increase in the prevalence of conceptions with trisomy 21 whereas the prevalence of live births with Down's syndrome remained the same. The reasons for this are an increase in the age of the mothers and a broad acceptance of prenatal diagnostics. Ethical questions, that might for example reveal societal changes in the attitude to children with Down's syndrome have not been considered in the analysis, since this would require sociological investigations which cannot be carried out by the malformations register.