Abstract
BackgroundThe 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.MethodPubMed 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.ResultsSeventeen 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.ConclusionThis 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.
Highlights
Intellectual disability (ID) or mental retardation (MR) is a developmental disability characterized by significant limitations in both intellectual functioning and adaptive behavior
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
It is suggested that the risk factors for non-genetic ID are extensive, and can be classified as prenatal, perinatal and neonatal factors according to the timing of suffering
Summary
Intellectual disability (ID) or mental retardation (MR) is a developmental disability characterized by significant limitations in both intellectual functioning and adaptive behavior. ID can be classified as genetic or non-genetic depending on its etiology. The causes of genetic ID, which accounts for only 30% to 50% of all ID cases[3], include chromosomal abnormalities (e.g. trisomy 21 syndrome), inherited genetic traits (e.g. fragile X syndrome) and single gene disorders (e.g. Prader—Willi syndrome)[4, 5]. The causes of non-genetic ID are not fully known. It is suggested that the risk factors for non-genetic ID are extensive, and can be classified as prenatal, perinatal and neonatal factors according to the timing of suffering. 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
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