Leonard Helen, Nassar Natasha, Bourke Jenny, Blair Eve, Mulroy Seonaid, de Klerk Nicholas, Bower Carol
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, West Perth, Australia.
Am J Epidemiol. 2008 Jan 1;167(1):103-11. doi: 10.1093/aje/kwm245. Epub 2007 Sep 26.
The authors investigated the association between intrauterine growth and intellectual disability (ID). The appropriateness of intrauterine growth was assessed using percentage of optimal birth weight, a measure that accounts for gestational age, maternal height, parity, and infant sex. Using population-based record linkage, singleton Caucasian and Aboriginal children born in Western Australia in 1983-1992 and alive in 2002 with ID of unknown cause (n = 2,625) were compared with children without ID (n = 217,252). The odds of ID increased with less-than-optimal intrauterine growth. In Caucasian children, after adjustment for sociodemographic factors, severe growth restriction was associated with development of mild-moderate ID among preterm births (<37 weeks) (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.06, 2.77) and term births (> or =37 weeks) (OR = 2.42, 95% CI: 1.88, 3.12) and with severe ID (OR = 4.79, 95% CI: 2.59, 8.83) among term births. Effects were similar among Aboriginal children. Severe growth restriction (OR = 3.2, 95% CI: 1.3, 7.9) and poor head growth (OR = 3.6, 95% CI: 1.4, 9.0) were independently associated with severe ID. Infants with excess intrauterine growth were more likely to be diagnosed with ID associated with autism spectrum disorder (OR = 2.36, 95% CI: 0.93, 6.03). These findings suggest that inappropriate intrauterine growth, less than or greater than optimal birth weight, is associated with development of ID.
作者们调查了子宫内生长与智力残疾（ID）之间的关联。子宫内生长的适宜性通过最佳出生体重百分比来评估，该指标考虑了孕周、母亲身高、产次和婴儿性别。利用基于人群的记录链接，将1983年至1992年在西澳大利亚出生且2002年仍存活、病因不明的单胎白种人和原住民儿童（n = 2625）与无智力残疾的儿童（n = 217252）进行比较。智力残疾的几率随着子宫内生长未达最佳状态而增加。在白种儿童中，在调整社会人口统计学因素后，严重生长受限与早产（<37周）中的轻度至中度智力残疾的发生相关（比值比（OR）= 1.71，95%置信区间（CI）：1.06，2.77）以及足月产（≥37周）中的轻度至中度智力残疾相关（OR = 2.42，95% CI：1.88，3.12），并且与足月产中的重度智力残疾相关（OR = 4.79，95% CI：2.59，8.83）。原住民儿童中的效应相似。严重生长受限（OR = 3.2，95% CI：1.3，7.9）和头部生长不良（OR = 3.6，95% CI：1.4，9.0）与重度智力残疾独立相关。子宫内生长过度的婴儿更有可能被诊断为与自闭症谱系障碍相关的智力残疾（OR = 2.36，95% CI：0.93，6.03）。这些发现表明，子宫内生长不当，即低于或高于最佳出生体重，与智力残疾的发生相关。
