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在肯雅塔国家医院就诊的2至18岁儿童中,与非遗传性智力残疾(智力发育迟缓)严重程度相关的风险因素

Risk Factors Associated with Severity of Nongenetic Intellectual Disability (Mental Retardation) among Children Aged 2-18 Years Attending Kenyatta National Hospital.

作者信息

Nemerimana Mathieu, Chege Margaret Njambi, Odhiambo Eunice Ajode

机构信息

School of Nursing Sciences, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya.

Department of Nursing and Midwifery, Kibogora Polytechnic, P.O. Box 31, Rusizi, Rwanda.

出版信息

Neurol Res Int. 2018 Apr 18;2018:6956703. doi: 10.1155/2018/6956703. eCollection 2018.

DOI:10.1155/2018/6956703
PMID:29850243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5932422/
Abstract

BACKGROUND

Many of the nongenetic causal risk factors of intellectual disability (ID) can be prevented if they are identified early. There is paucity on information regarding potential risk factors associated with this condition in Kenya. This study aimed to establish risk factors associated with severity of nongenetic intellectual disability (ID) among children presenting with this condition at Kenyatta National Hospital (KNH).

METHODS

A hospital-based cross-sectional study was conducted over the period between March and June 2017 in pediatric and child/youth mental health departments of Kenyatta National Hospital (KNH), Kenya. It included children aged 2-18 years diagnosed with ID without underlying known genetic cause.

RESULTS

Of 97 patients with nongenetic ID, 24% had mild ID, 40% moderate, 23% severe-profound, and 10% unspecified ID. The mean age of children was 5.6 (±3.6) years. Male children were predominant (62%). Three independent factors including "labor complications" [AOR = 9.45, 95% CI = 1.23-113.29, = 0.036], "admission to neonatal intensive care unit" [AOR = 8.09, 95% CI = 2.11-31.07, = 0.002], and "cerebral palsy" [AOR = 21.18, CI = 4.18-107.40, ≤ 0.001] were significantly associated with increased risk of severe/profound nongenetic ID.

CONCLUSION

The present study findings suggest that perinatal complications as well as postnatal insults are associated with increased risk of developing severe-profound intellectual disability, implying that this occurrence may be reduced with appropriate antenatal, perinatal, and neonatal healthcare interventions.

摘要

背景

如果能早期识别,许多智力残疾(ID)的非遗传致病风险因素是可以预防的。在肯尼亚,关于与这种情况相关的潜在风险因素的信息匮乏。本研究旨在确定在肯雅塔国家医院(KNH)就诊的患有这种疾病的儿童中,与非遗传智力残疾(ID)严重程度相关的风险因素。

方法

2017年3月至6月期间,在肯尼亚肯雅塔国家医院(KNH)的儿科和儿童/青少年精神卫生科进行了一项基于医院的横断面研究。研究对象包括年龄在2至18岁之间、被诊断为ID且无已知潜在遗传病因的儿童。

结果

在97例非遗传ID患者中,24%为轻度ID,40%为中度,23%为重度-极重度,10%为未明确的ID。儿童的平均年龄为5.6(±3.6)岁。男性儿童占多数(62%)。三个独立因素包括“分娩并发症”[调整后比值比(AOR)=9.45,95%置信区间(CI)=1.23-113.29,P=0.036]、“入住新生儿重症监护病房”[AOR=8.09,95%CI=2.11-31.07,P=0.002]和“脑瘫”[AOR=21.18,CI=4.18-107.40,P≤0.001]与重度/极重度非遗传ID风险增加显著相关。

结论

本研究结果表明,围产期并发症以及产后损伤与发展为重度-极重度智力残疾的风险增加有关,这意味着通过适当的产前、围产期和新生儿保健干预措施,这种情况的发生率可能会降低。

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