<![CDATA[The prevalence of Down syndrome among children aged 24–59 months was detected at 0.12% in 2010, 0.13% in 2013, and 0.21% in 2018, or approximately 1 per 600 live births. The global incidence is estimated at 3,000– 5,000 infants born with Down syndrome each year. Based on CDC data, approximately 6,000 infants are born with Down syndrome (DS) each year, or about 1 in 700 live births. The incidence of DS in the United States (US) increased over the period 2010 2014, rising from 13.7 per 10,000 to 15.7 per 10,000 live births, or 1 in 772 infants born with DS. Early detection of Down syndrome plays a crucial role in improving clinical management and family preparedness. Delayed diagnosis of intellectual disability can cause children to miss the opportunity for early intervention, which can help reduce symptoms as well as behavioral and emotional problems, in addition to resulting in poorer cognitive and adaptive functioning compared with those who receive treatment early. This study aimed to describe the characteristics of children with Down syndrome, maternal characteristics, and the history of birth attendants, birth settings, and modes of delivery in Central Java, Indonesia. Specifically, the study aimed to examine the associations between birth attendant, birth setting, mode of delivery, and the timing of Down syndrome diagnosis in children. A correlational analytical design with a cross-sectional approach was employed to describe the characteristics of children with Down syndrome, maternal characteristics, and birth-related factors, including birth attendant, birth setting, and mode of delivery. The study also examined the associations between these factors and the child’s age at Down syndrome diagnosis. Bivariate analysis was performed using the Chi-square test, while multivariable analysis was conducted using binary logistic regression. The findings showed that the majority of children were male and were aged >5–12 years. Most mothers were aged 20–35 years at the time of delivery. Midwives were the most common birth attendants, spontaneous vaginal delivery was the predominant mode of delivery, and independent midwifery practices were the most frequent birth settings. Most children were diagnosed with Down syndrome during the neonatal period. Among the factors examined, birth attendant showed the strongest statistical association with early diagnosis]]>
