Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years

Public Health Genomics. 2016;19(5):290-7. doi: 10.1159/000448912. Epub 2016 Sep 6.

Abstract

Background: Intellectual disability (ID), characterized by impairments in intellectual function and adaptive behavior, affects 1-3% of the population. Many studies investigated its etiology, but few are cohort studies in middle-income countries.

Aims: To estimate prevalence, etiology, and factors related to ID among children prospectively followed since birth in a Southern Brazilian city (Pelotas).

Methods: In 2004, maternity hospitals were visited daily and births were identified. Live-born infants (n = 4,231) whose family lived in the urban area have been followed for several years. At the age of 2 and 4 years, performances in development and intelligence tests were evaluated using the Battelle Developmental Inventory and Wechsler Intelligence Scale, respectively. Children considered as having developmental delay were invited to attend a genetic evaluation.

Results: At 4 years of age, the prevalence of ID was 4.5%, and the etiology was classified into 5 groups: environmental (44.4%), genetic (20.5%), idiopathic (12.6%), neonatal sequelae (13.2%), other diseases (9.3%). Most children presented impairment in two or more areas of adaptive behavior. There was no difference in prenatal care attendance or maternal schooling among the groups.

Conclusion: For about 40% of children, ID was attributed to nonbiological factors, suggesting that the rate may be reduced with appropriate interventions early in life.

MeSH terms

  • Brazil / epidemiology
  • Child, Preschool
  • Cohort Studies
  • Disability Evaluation
  • Disabled Children / statistics & numerical data*
  • Environment*
  • Female
  • Genetic Testing* / methods
  • Genetic Testing* / statistics & numerical data
  • Humans
  • Intellectual Disability* / diagnosis
  • Intellectual Disability* / epidemiology
  • Intellectual Disability* / etiology
  • Intelligence Tests
  • Male
  • Needs Assessment
  • Prevalence