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Inherited Disorders and Birth Defects

Simian Crease on both hands



Our son is born with simian creases on both hands. When he was born, they did all the new born screening tests and we didnt hear anything from the docs. Also, when I was about 11+ wks pregnant, we did an NT test and all the tests came back negative. However, upon reading the symptoms for Down Syndrome (my husband was chatting casually with his co-worker about DS and just happened to check to see what the signs of DS are), we discovered that simian crease is one of the symptom. My son will be 2 months on 10/8 and we have his 2-month well visit in a few days. My question is what signs should we be looking out for for DS or other birth defects. Thank you for your help.


A single palmer crease or simian crease is a single transverse crease across the palm of the hand which can be a normal variation of palmer creases. About 4% of the general population has a single palmer crease on one hand and about 1% will have it on both palms. Also, less than half of the children diagnosed with Down syndrome will have single palmer creases.

I would recommend that you discuss this with your pediatrician when he sees your son. Most infants with Down syndrome have characteristic facial features such as a flattening of the mid face and nose, the eye might be widely spaced, the eyes usually slant upwards and the back of the head might be somewhat flat. Babies with Down syndrome often have low muscle tone as well, so they are delayed in reaching developmental milestones such as holding their head up, sitting and walking. These are things that your doctor can look for when he examines the baby.

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Response by:

Anne   Matthews, RN, PhD Anne Matthews, RN, PhD
Associate Professor of Genetics
School of Medicine
Case Western Reserve University