出生头围与智力障碍：一项全国性队列研究。
Head circumference at birth and intellectual disability: a nationwide cohort study.
机构信息
Perinatal Epidemiology Research Unit & Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Pediatrics and Adolescent Medicine, Randers Regional Hospital, Randers, Denmark.
出版信息
Pediatr Res. 2020 Feb;87(3):595-601. doi: 10.1038/s41390-019-0593-3. Epub 2019 Oct 2.
BACKGROUND
Intellectual disability (ID) is a prevalent chronic disability affecting up to 1-3% of the general population. Small head circumference at birth, a surrogate measure of foetal cerebral growth, may be a risk factor for ID. We aimed to investigate the association between the full distribution of head circumference at birth and ID.
METHODS
This cohort study was based on Danish nationwide registries and included all Danish singletons born alive from 1997 to 2013. Follow-up ended at October 2015. The data was analysed using a Cox proportional hazards regression model adjusted for a large number of potential confounders.
RESULTS
The cohort comprised 986,909 infants. Neither microcephaly nor macrocephaly at birth was consistently associated with the risk of ID. Within the normal range of head circumference, larger head circumference was associated with a decreased risk of ID (HR per standard deviation increase in head circumference z score 0.85, 95% CI 0.81-0.88). The association detected within the normal range was consistent in all sensitivity analyses.
CONCLUSIONS
Intrauterine brain growth restriction may be a risk factor for ID.
背景
智力障碍（ID）是一种普遍存在的慢性残疾，影响着高达 1-3%的普通人群。出生时的小头围，作为胎儿大脑生长的替代测量指标，可能是 ID 的一个风险因素。我们旨在研究出生时头围的全部分布与 ID 之间的关系。
方法
这项队列研究基于丹麦全国性登记处，纳入了 1997 年至 2013 年期间所有丹麦活产单胎。随访于 2015 年 10 月结束。使用 Cox 比例风险回归模型对大量潜在混杂因素进行了调整，对数据进行了分析。
结果
该队列包括 986909 名婴儿。出生时的小头畸形或大头畸形与 ID 风险均无一致关联。在头围的正常范围内，较大的头围与 ID 风险降低相关（头围 Z 评分每增加一个标准差的 HR 为 0.85，95%CI 0.81-0.88）。在所有敏感性分析中，在正常范围内检测到的关联是一致的。
结论
宫内大脑生长受限可能是 ID 的一个风险因素。
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