Fairthorne Jenny, Hammond Geoff, Bourke Jenny, Jacoby Peter, Leonard Helen
Telethon Kids Institute, University of Western Australia, Perth, Australia.
Health Department of Western Australia, Perth, Australia.
PLoS One. 2014 Dec 23;9(12):e113430. doi: 10.1371/journal.pone.0113430. eCollection 2014.
Mothers of children with intellectual disability or autism spectrum disorder (ASD) have poorer health than other mothers. Yet no research has explored whether this poorer health is reflected in mortality rates or whether certain causes of death are more likely. We aimed to calculate the hazard ratios for death and for the primary causes of death in mothers of children with intellectual disability or ASD compared to other mothers.
The study population comprised all mothers of live-born children in Western Australia from 1983-2005. We accessed state-wide databases which enabled us to link socio-demographic details, birth dates, diagnoses of intellectual disability or ASD in the children and dates and causes of death for all mothers who had died prior to 2011. Using Cox Regression with death by any cause and death by each of the three primary causes as the event of interest, we calculated hazard ratios for death for mothers of children intellectual disability or ASD compared to other mothers.
During the study period, mothers of children with intellectual disability or ASD had more than twice the risk of death. Mothers of children with intellectual disability were 40% more likely to die of cancer; 150% more likely to die of cardiovascular disease and nearly 200% more likely to die from misadventure than other mothers. Due to small numbers, only hazard ratios for cancer were calculated for mothers of children with ASD. These mothers were about 50% more likely to die from cancer than other mothers. Possible causes and implications of our results are discussed.
Similar studies, pooling data from registries elsewhere, would improve our understanding of factors increasing the mortality of mothers of children with intellectual disability or ASD. This would allow the implementation of informed services and interventions to improve these mothers' longevity.
智障或自闭症谱系障碍（ASD）儿童的母亲健康状况比其他母亲更差。然而，尚无研究探讨这种较差的健康状况是否反映在死亡率上，或者某些死因是否更有可能出现。我们旨在计算智障或ASD儿童母亲与其他母亲相比的死亡风险比以及主要死因的风险比。
研究人群包括1983年至2005年在西澳大利亚州出生的所有活产儿童的母亲。我们访问了全州范围的数据库，这些数据库使我们能够将社会人口统计学细节、出生日期、儿童智障或ASD的诊断以及2011年之前死亡的所有母亲的死亡日期和死因联系起来。以任何原因导致的死亡以及三种主要原因中的每一种导致的死亡作为感兴趣的事件，使用Cox回归分析，我们计算了智障或ASD儿童母亲与其他母亲相比的死亡风险比。
在研究期间，智障或ASD儿童的母亲死亡风险是其他母亲的两倍多。智障儿童的母亲死于癌症的可能性高出40%；死于心血管疾病的可能性高出150%，死于意外事故的可能性比其他母亲高出近200%。由于数量较少，仅计算了ASD儿童母亲患癌症的风险比。这些母亲死于癌症的可能性比其他母亲高出约50%。我们讨论了结果的可能原因和影响。
汇总其他地区登记处数据的类似研究将增进我们对增加智障或ASD儿童母亲死亡率因素的理解。这将有助于实施明智的服务和干预措施，以提高这些母亲的寿命。
