Early Mortality and Primary Causes of Death in Mothers of Children with Intellectual Disability or Autism Spectrum Disorder: A Retrospective Cohort Study
Early Mortality and Primary Causes of Death in Mothers of Children with Intellectual Disability or Autism Spectrum Disorder: A Retrospective Cohort Study
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DOI：
10.1371/journal.pone.0113430
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发表时间：
2014-12-23
期刊：
影响因子：
3.7
通讯作者：
Leonard, Helen
中科院分区：
文献类型：
--
作者：
Fairthorne, Jenny;Hammond, Geoff;Leonard, Helen
引言：智力残疾或自闭症谱系障碍（ASD）儿童的母亲比其他母亲的健康状况更差。然而，还没有研究探讨这种更差的健康状况是否反映在死亡率上，或者某些死亡原因是否更有可能。我们的目的是计算死亡的风险比，并为主要死亡原因的儿童智力残疾或ASD的母亲相比，其他mother.Methods：研究人群包括所有母亲的活产儿童在西澳大利亚州从1983年至2005年。我们访问了全州范围的数据库，使我们能够将社会人口统计学细节，出生日期，儿童智力残疾或ASD的诊断以及2011年之前死亡的所有母亲的死亡日期和原因联系起来。使用考克斯回归与死亡的任何原因和死亡的三个主要原因作为感兴趣的事件，我们计算了死亡的危险比为母亲的儿童智力残疾或ASD相比，其他mother.Results和讨论：在研究期间，母亲的儿童智力残疾或ASD的死亡风险的两倍以上。与其他母亲相比，智力残疾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%，死于意外的可能性高出近200%。由于人数较少，仅计算了患有ASD儿童的母亲的癌症风险比。这些母亲死于癌症的可能性比其他母亲高出50%。可能的原因和影响，我们的研究结果进行了讨论。结论：类似的研究，汇集其他地方的登记数据，将提高我们的理解因素增加的母亲的智力残疾或ASD儿童的死亡率。这将有助于实施知情服务和干预措施，延长这些母亲的寿命。
Introduction: 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.Methods: 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.Results and Discussion: 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.Conclusion: 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.