Down's syndrome: The effects of prenatal diagnosis and demographic factorsin a region of the eastern part of Germany

The epidemiological analysis of trisomy 21 presented for the new federal Ge rman state of Saxony-Anhalt describes trends and changes in the frequency o f Down's syndrome and prevalences of the pregnancy outcomes including accep tance of prenatal diagnostic measures in the period from 1980 and with sepa rate analysis for the period since reunification in 1990. The average preva lence 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 a re an increase in the age of the mothers and a broad acceptance of prenatal diagnostics. Ethical questions, that might for example reveal societal cha nges in the attitude to children with Down's syndrome have not been conside red in the analysis, since this would require sociological investigations w hich cannot be carried out by the malformations register.