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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Maternal and neonatal risk factors for mental retardation: defining the 'at-risk' child
B W Camp1, S H Broman, P L Nichols
1Department of Pediatrics, University of Colorado, School of Medicine, Denver, USA.
Insights
Low socioeconomic status and maternal education are key predictors of mental retardation in children. Identifying these risk factors early can help define infant risk status.
Area of Science:
- Developmental Pediatrics
- Public Health
- Genetics
Background:
- Mental retardation (MR) diagnosis at age seven is influenced by various factors.
- Understanding these associations is crucial for early identification and intervention.
Purpose of the Study:
- To investigate the relationship between maternal, perinatal, and neonatal characteristics and mental retardation at age seven.
- To establish a ranking of early developmental events based on their association with MR.
Main Methods:
- Utilized data from 35,704 children in the Collaborative Perinatal Project, followed from prenatal period to age seven.
- Collected data on nine maternal/pregnancy characteristics and 12 neonatal factors.
Main Results:
- Low socioeconomic status (SES) and low maternal education were significant predictors of MR.
- Maternal IQ < 70, low pregnancy weight gain, and multiple births increased risk.
- Specific factors like maternal anemia (in Black infants) and UTIs (in White infants) showed ethnic variations in risk.
- Genetic syndromes, CNS malformations, cerebral palsy, seizures, low birth weight, and low APGAR scores were associated with increased MR risk.
- In low SES Black infants, low APGAR, primary apnea, and abnormal growth parameters further elevated risk.
Conclusions:
- Early developmental events can be ranked by their association strength with mental retardation.
- These rankings can serve as a guide for identifying infants at risk in early infancy.
Objective:
To determine how mental retardation at age seven is related to certain maternal, perinatal, and neonatal characteristics.
Method:
A sample of 35,704 children followed from the prenatal period to age 7 years in the Collaborative Perinatal Project provided data on nine maternal and pregnancy characteristics and 12 neonatal factors.
Results:
Low socioeconomic status of the family (SES) accounted for 44-50% of mental retardation and a low level of maternal education accounted for 20%. Other prenatal factors with significantly elevated relative risks, (P < 0.05) were maternal IQ score less than 70, weight gain in pregnancy less than 10 pounds and multiple birth. Maternal anemia in pregnancy accounted for 14% of mental retardation in blacks, and, urinary tract infections accounted for 6% of mental retardation in whites. Significant elevations in relative risk were found for major genetic and post-infection syndromes, CNS malformations, cerebral palsy, seizures, abnormal movements or tone, and low birth weight. Relative risk was also significantly increased with low 1 minute APGAR, primary apnea, and head circumference and length more than 2 SD below average but only in the low SES black subgroup.
Conclusion:
Early developmental events can be ranked on the basis of the strength of their association with mental retardation and such rankings can be used as a guide for defining risk status in early infancy.
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