Primary megalencephaly at birth and low intelligence level

To evaluate the association between primary megalencephaly (PMG) at birth and psychosensory conditions and to determine mother-child similarity for PMG at birth.

PMG is defined as a head circumference (HC) above the 98th percentile that most likely is due to brain enlargement and is not secondary to disease. Previously, PMG in children was reported to be associated with learning disabilities. Contradictory results regarding an association between PMG and intelligence in children exist. Many believe PMG expressed in childhood and adulthood may be inherited.

Birth records on HC from 144,273 boys, of whom 732 had PMG, were linked to data concerning intelligence level, mental retardation, and impairment of vision and hearing. A potential association between PMG at birth and mental retardation was also examined in 3,204 mentally retarded boys and girls. Parent-offspring similarity for PMG at birth was determined in 13,585 mother-child pairs.

PMG was significantly associated with low intelligence level (odds ratio, 1.32; 95% confidence interval [CI], 1.11 to 1.38). The estimated odds ratio for mental retardation in PMG cases versus controls was 1.31 (95% CI, 0.80 to 2.02). There were no differences in frequencies of vision and hearing impairments between PMG cases and controls. Associations between mother's and child's birth weight-normalized HC (r = 0.14; p<0.0001) and PMG (odds ratio, 2.55; CI, 2.00 to 3.25) were found, supporting a multifactorial inheritance of PMG.

PMG at birth is a risk factor for low intelligence level but not for vision and hearing impairments. The heritability of HC and PMG is moderate.