Laura A Schieve1, Lin H Tian2, Kristin Rankin3, Michael D Kogan4, Marshalyn Yeargin-Allsopp2, Susanna Visser2, Deborah Rosenberg3. 1. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: lschieve@cdc.gov. 2. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. 3. School of Public Health, University of Illinois at Chicago, Chicago. 4. Maternal and Child Health Bureau, Health Services and Research Administration, Rockville, MD.
Abstract
PURPOSE: Although previous studies demonstrate associations between adverse perinatal outcomes and developmental disabilities (DDs), study of population impacts is limited. METHODS: We computed relative risks adjusted (aRRs) for sociodemographic factors and component and summary population attributable fractions (PAFs) for associations between very low birth weight (VLBW, all preterm births), moderately low birth weight (MLBW) + Preterm, MLBW at term, and normal birth weight (NBW) + Preterm and seven DDs (cerebral palsy [CP], autism spectrum disorder [ASD], intellectual disability [ID], behavioral-conduct disorders, attention-deficit-hyperactivity disorder [ADHD], learning disability [LD], and other developmental delay) among children aged 3-17 years in the 2011-2012 National Survey of Children's Health. RESULTS: VLBW-Preterm, MLBW-Preterm and NBW-Preterm were strongly to moderately associated with CP (aRRs: 43.5, 10.1, and 2.2, respectively; all significant) and also associated with ID, ASD, LD, and other developmental delay (aRR ranges: VLBW-Preterm 2.8-5.3; MLBW-Preterm 1.9-2.8; and NBW-Preterm 1.6-2.3). Summary PAFs for preterm birth and/or LBW were 55% for CP, 10%-20% for ASD, ID, LD, and other developmental delay, and less than 5% for ADHD and behavioral-conduct disorders. Findings were similar whether we assessed DDs as independent outcomes or within mutually exclusive categories accounting for DD co-occurrence. CONCLUSIONS: Preterm birth has a sizable impact on child neurodevelopment. However, relative associations and population impacts vary widely by DD type.
PURPOSE: Although previous studies demonstrate associations between adverse perinatal outcomes and developmental disabilities (DDs), study of population impacts is limited. METHODS: We computed relative risks adjusted (aRRs) for sociodemographic factors and component and summary population attributable fractions (PAFs) for associations between very low birth weight (VLBW, all preterm births), moderately low birth weight (MLBW) + Preterm, MLBW at term, and normal birth weight (NBW) + Preterm and seven DDs (cerebral palsy [CP], autism spectrum disorder [ASD], intellectual disability [ID], behavioral-conduct disorders, attention-deficit-hyperactivity disorder [ADHD], learning disability [LD], and other developmental delay) among children aged 3-17 years in the 2011-2012 National Survey of Children's Health. RESULTS: VLBW-Preterm, MLBW-Preterm and NBW-Preterm were strongly to moderately associated with CP (aRRs: 43.5, 10.1, and 2.2, respectively; all significant) and also associated with ID, ASD, LD, and other developmental delay (aRR ranges: VLBW-Preterm 2.8-5.3; MLBW-Preterm 1.9-2.8; and NBW-Preterm 1.6-2.3). Summary PAFs for preterm birth and/or LBW were 55% for CP, 10%-20% for ASD, ID, LD, and other developmental delay, and less than 5% for ADHD and behavioral-conduct disorders. Findings were similar whether we assessed DDs as independent outcomes or within mutually exclusive categories accounting for DD co-occurrence. CONCLUSIONS:Preterm birth has a sizable impact on child neurodevelopment. However, relative associations and population impacts vary widely by DD type.
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