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An epidemiological study of disability in 4-year-old children from a birth cohort in Frederiksborg County, Denmark
E Andersen1, H C Fledelius, M Føns
1Department of Pediatrics, Frederiksborg County Hospital, Hillerød.
Insights
Most childhood disabilities stem from prenatal factors, not birth complications. This study highlights the importance of prenatal care in preventing developmental disorders in children.
Area of Science:
- Pediatrics
- Epidemiology
- Developmental Neurology
Background:
- Childhood disability presents a significant public health challenge.
- Understanding the etiological factors is crucial for effective prevention strategies.
Purpose of the Study:
- To determine the prevalence of various childhood disabilities from birth to age four.
- To investigate the contribution of prenatal, perinatal, and postnatal factors to disability.
Main Methods:
- Epidemiological cohort study of 4,138 liveborn children.
- Data collected through surveys at age four.
- Prevalence rates calculated for motor handicap, intellectual disability, epilepsy, and sensory defects.
Main Results:
- Overall disability prevalence was 1.1% (45 children).
- Prenatal causes or combined prenatal/perinatal factors accounted for two-thirds of disabilities.
- Birth asphyxia was a rare cause; prematurity increased risk for spastic diplegia but not intellectual disability.
Conclusions:
- Prenatal factors are the primary contributors to childhood disability.
- Perinatal events and birth asphyxia play a limited role.
- Further research into prenatal risk factors is warranted to inform interventions.
Abstract:
In an epidemiological study of a county cohort of 4,138 liveborn children, surveyed at age four, 45 had disability (1.1%). The following period prevalences from birth to age four in per mille were found: motor handicap 5.1, to include cerebral palsy 4.1, myelomeningocele and hydrocephalus 0.5, and metabolic disorders 0.5; severe mental retardation 2.9, mild 1.4, subnormality 2.7; epilepsy 4.6; severe visual defect 1.4; severe auditory defect 0.7. Perinatal damage alone was likely in only three children out of 45. Two thirds had a prenatal cause or a combination of prenatal and perinatal causes. Birth asphyxia seemed to be a rare cause of motor disability and mental retardation. Prematurity per se gave a risk of spastic diplegia, but not of mental retardation. Among the mentally retarded, half were light for gestational age, and in more than half, the damage occurred prenatally.