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Abstract
Preterm birth is linked to intellectual disability and there is evidence to suggest post-term birth may also incur risk. However, these associations have not yet been investigated in the absence of common genetic causes of intellectual disability, where risk associated with late delivery may be preventable. We therefore aimed to examine risk of intellectual disability without a common genetic cause across the entire range of gestation, using a matched-sibling design to account for unmeasured confounding by shared familial factors. We conducted a population-based retrospective study using data from the Stockholm Youth Cohort (n = 499,621) and examined associations in a nested cohort of matched outcome-discordant siblings (n = 8034). Risk of intellectual disability was greatest among those born extremely early (adjusted OR24 weeks = 14.54 [95% CI 11.46–18.44]), lessening with advancing gestational age toward term (aOR32 weeks = 3.59 [3.22–4.01]; aOR37 weeks = 1.50 [1.38–1.63]); aOR38 weeks = 1.26 [1.16–1.37]; aOR39 weeks = 1.10 [1.04–1.17]) and increasing with advancing gestational age post-term (aOR42 weeks = 1.16 [1.08–1.25]; aOR43 weeks = 1.41 [1.21–1.64]; aOR44 weeks = 1.71 [1.34–2.18]; aOR45 weeks = 2.07 [1.47–2.92]). Associations persisted in a cohort of matched siblings suggesting they were robust against confounding by shared familial traits. Risk of intellectual disability was greatest among children showing evidence of fetal growth restriction, especially when birth occurred before or after term. Birth at non-optimal gestational duration may be linked causally with greater risk of intellectual disability. The mechanisms underlying these associations need to be elucidated as they are relevant to clinical practice concerning elective delivery around term and mitigation of risk in post-term children.
Original language | English |
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Pages (from-to) | 1-12 |
Number of pages | 12 |
Journal | European Journal of Epidemiology |
Early online date | 6 Dec 2017 |
DOIs | |
Publication status | E-pub ahead of print - 6 Dec 2017 |
Keywords
- Gestational age
- Intellectual disability
- Post-term birth
- Regression splines
- Siblings
- Stockholm Youth Cohort
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Dive into the research topics of 'Gestational age at birth and risk of intellectual disability without a common genetic cause'. Together they form a unique fingerprint.Projects
- 1 Finished
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NIHR BRC Mental Health
Gunnell, D. J. (Principal Investigator)
1/04/17 → 31/03/22
Project: Research, Parent
Profiles
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Professor Dheeraj Rai
- Bristol Medical School (PHS) - Professor of Neurodevelopmental Psychiatry
- Migration Mobilities Bristol
- Bristol Population Health Science Institute
- Centre for Academic Mental Health
Person: Academic , Member