Zhen Huiling, McDermott Suzanne, Lawson Andrew B, Aelion Marjorie
Department of Epidemiology & Biostatistics, University of South Carolina, USA.
Geospat Health. 2009 Nov;4(1):17-26. doi: 10.4081/gh.2009.207.
Mental retardation (MR) is a subset of developmental delay (DD), a broader classification of childhood disability. The purpose of this study was to determine if clusters of these two conditions were statistically significantly correlated. The residential addresses of 81,935 Medicaid insured pregnant women during each month of pregnancy were used to identify clusters of MR and DD in their children. Correlations between MR and DD were computed based on the sets of P-value surface from selected centroid points, where the P-value for cumulative relative risk of MR and DD was known. The correlations are quite small for all the 10 gestational months for which maternal addresses were available, but they are all statistically significant. This indicates MR and DD are correlated, but they are not linear. When MR was used as the centroid point to identify a cluster the only correlations that were statistically significant were for gestational month 5 and 6 with correlation 0.14 (P = 0.007) for both months. When the centroid points were selected based on the significance of risk of DD, the correlations between MR and DD are not statistically significant for any month. Correlation between MR and DD based on the sets of P-value surfaces from 4 MR clusters are significant in gestational month 5, 6 and 7 with correlation 0.17 (P = 0.047), 0.16 (P = 0.060) and 0.17 (P = 0.044), respectively. Our finding suggests that locations of high risk for the more severe condition, MR, also identify a spatial area where less severe cases of DD might be present, however the reverse is not the case.
智力迟钝(MR)是发育迟缓(DD)的一个子集,发育迟缓是对儿童残疾更广泛的分类。本研究的目的是确定这两种情况的集群是否在统计学上具有显著相关性。利用81935名参加医疗补助保险的孕妇在孕期每个月的居住地址,来识别其子女中智力迟钝和发育迟缓的集群。基于选定质心点的P值曲面集计算智力迟钝和发育迟缓之间的相关性,其中智力迟钝和发育迟缓累积相对风险的P值是已知的。对于有母亲地址信息的所有10个孕周,相关性都相当小,但在统计学上均具有显著性。这表明智力迟钝和发育迟缓是相关的,但不是线性相关。当以智力迟钝作为质心点来识别集群时,仅在孕5个月和孕6个月时相关性在统计学上具有显著性,这两个月的相关性均为0.14(P = 0.007)。当根据发育迟缓风险的显著性来选择质心点时,智力迟钝和发育迟缓之间的相关性在任何月份均无统计学显著性。基于4个智力迟钝集群的P值曲面集,智力迟钝与发育迟缓在孕5个月、孕6个月和孕7个月的相关性具有显著性,分别为0.17(P = 0.047)、0.16(P = 0.060)和0.17(P = 0.044)。我们的研究结果表明,较严重情况即智力迟钝的高风险位置,也确定了一个可能存在较轻发育迟缓病例的空间区域,然而反之则不然。