Associations of birth defects with adult intellectual performance, disability and mortality:: Population-based cohort study
Associations of birth defects with adult intellectual performance, disability and mortality:: Population-based cohort study
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DOI：
10.1203/01.pdr.0000219172.16638.f9
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发表时间：
2006-06-01
影响因子：
3.6
通讯作者：
Oyen, N
中科院分区：
文献类型：
--
作者：
Eide, MG;Skærven, R;Oyen, N
出生缺陷的婴儿在死亡率和残疾方面的结局较差，但出生缺陷儿童的长期智力结果通常是未知的。我们评估了各种出生缺陷与死亡率和残疾的长期关系，并评估了高死亡率和残疾是否反映在18岁时智力表现的损害上。在这项全国性的队列研究中，挪威医学出生登记处(1967-1979)登记的9,186名患有出生缺陷的男性和384,384名无出生缺陷的男性的记录与国家征兵服务(1984-1999)有关。征兵前的死亡率和伤残，以及征兵时的智力测试分数是主要的结果指标。有出生缺陷的男性与没有出生缺陷的男性相比，残疾的相对风险为6.0。在与低死亡率相关的出生缺陷类别中，残疾程度较低，而在与高死亡率相关的缺陷类别中，残疾程度较高。如果母亲的教育水平较低，则未被征召入伍的相对风险最高。在调整了母亲教育、母亲年龄、婚姻状况和出生顺序后，心脏缺陷和腭裂是智力表现较低的唯一两个亚组。特别是，与单一缺陷相比，有多个缺陷的人的智力表现没有受到损害。我们的结论是，对于目前出生队列中的大多数出生缺陷类别，我们关于智力表现将受到损害的假设并未得到证实。因此，似乎没有什么理由担心有出生缺陷的非残疾幸存婴儿的智力不良后果。
Infants born with birth defects have poorer outcomes in terms of mortality and disability, but the long-term intellectual outcome in children with birth defects is generally unknown. We assessed the long-term associations of various birth defects with mortality and disability, and evaluated whether high mortality and disability were reflected in impaired intellectual performance at age 18. In this nationwide cohort study, records of 9,186 males with and 384,384 without birth defects, registered in the Medical Birth Registry of Norway (1967-1979) were linked to the National Conscript Service (1984-1999). Mortality and disability before military draft, and intelligence test score at conscription were the main outcome measures. Males with birth defects had a relative risk for disability of 6.0 compared with males without defects. Disability was low within categories of birth defects associated with low mortality, and high within defect categories associated with high mortality. The relative risk for not being drafted was highest if maternal educational level was low. Heart defects and cleft palate were the only subgroups in which intellectual performance was lower after adjustment for maternal education, maternal age, marital status and birth order. In particular, intellectual performance was not impaired among those with multiple compared with single defects. We conclude that for the majority of birth defect categories in the present birth cohort, our hypothesis that intellectual performance would be impaired was not confirmed. Thus, there seems to be little reason to fear an adverse intellectual outcome in non-disabled surviving infants with birth defects.