Prenatal, Perinatal and Neonatal Risk Factors for Intellectual Disability: A Systemic Review and Meta-Analysis

Jichong Huang; Tingting Zhu; Yi Qu; Dezhi Mu

doi:10.1371/journal.pone.0153655

Prenatal, Perinatal and Neonatal Risk Factors for Intellectual Disability: A Systemic Review and Meta-Analysis

PLoS One. 2016 Apr 25;11(4):e0153655. doi: 10.1371/journal.pone.0153655. eCollection 2016.

Authors

Jichong Huang^{1

2}, Tingting Zhu^{1

2}, Yi Qu^{1

2}, Dezhi Mu^{1

2

3}

Affiliations

¹ Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
² Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, 610041, China.
³ Department of Pediatrics, University of California San Francisco, San Francisco, CA, 94143, United States of America.

Abstract

Background: The etiology of non-genetic intellectual disability (ID) is not fully known, and we aimed to identify the prenatal, perinatal and neonatal risk factors for ID.

Method: PubMed and Embase databases were searched for studies that examined the association between pre-, peri- and neonatal factors and ID risk (keywords "intellectual disability" or "mental retardation" or "ID" or "MR" in combination with "prenatal" or "pregnancy" or "obstetric" or "perinatal" or "neonatal". The last search was updated on September 15, 2015. Summary effect estimates (pooled odds ratios) were calculated for each risk factor using random effects models, with tests for heterogeneity and publication bias.

Results: Seventeen studies with 55,344 patients and 5,723,749 control individuals were eligible for inclusion in our analysis, and 16 potential risk factors were analyzed. Ten prenatal factors (advanced maternal age, maternal black race, low maternal education, third or more parity, maternal alcohol use, maternal tobacco use, maternal diabetes, maternal hypertension, maternal epilepsy and maternal asthma), one perinatal factor (preterm birth) and two neonatal factors (male sex and low birth weight) were significantly associated with increased risk of ID.

Conclusion: This systemic review and meta-analysis provides a comprehensive evidence-based assessment of the risk factors for ID. Future studies are encouraged to focus on perinatal and neonatal risk factors and the combined effects of multiple factors.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adolescent
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Intellectual Disability / epidemiology*
Risk Factors

Grants and funding

This work was supported by the National Science Foundation of China (No. 81330016, 81300524, 81172174, 81270724 and 81200462), grants from the State Commission of Science Technology of China (2013CB967404, 2012BAI04B04), grants from the Ministry of Education of China (IRT0935, 313037), grants from the Science and Technology Bureau of Sichuan province (2014SZ0149, 2016TD0002), and a grant of clinical discipline program (neonatology) from the Ministry of Health of China (1311200003303).