Article

The aim of this study was to examine the association between maternal alcohol
use disorder and intellectual disability in children. Method All mothers with an
International Classification of Diseases (ICD) 9 and /or 10 alcohol-related
diagnosis, a proxy for alcohol use disorder, recorded on the Western Australian
health, mental health, and drug and alcohol data sets were identified through the
Western Australian Data Linkage Unit (n=5614 non-Aboriginal; n=2912 Aboriginal).
A comparison cohort of mothers without an alcohol-related diagnosis was frequency
matched on maternal age within maternal Aboriginal status and year of birth of
their children. Linkage with the Western Australian Midwives Notification System
(1983-2001) identified all births to these mothers (n=10 664 and 7907
respectively). Linkage to the Western Australian Intellectual Disability Database
and Register of Developmental Anomalies identified cases of intellectual
disability with no identified genetic origin (intellectual disability) (n=1487)
and fetal alcohol syndrome (n=66). Odds ratios (ORs) and 95% confidence intervals
(CIs) for intellectual disability were calculated using logistic regression
incorporating generalized estimating equations and used to estimate
population-attributable fractions. Results At least 3.8% (95% CI 2.84-4.89%) of
cases of intellectual disability could be avoided by preventing maternal alcohol
use disorder: 1.3% (95% CI 0.81-1.86%) in non-Aboriginal and 15.6% (95% CI
10.85-20.94%) in Aboriginal children. We observed a three-fold increase in the
adjusted odds of intellectual disability in children of mothers with an
alcohol-related diagnosis recorded during pregnancy (non-Aboriginal OR 2.89, 95%
CI 1.62-5.18; Aboriginal OR 3.12, 95% CI 2.13-4.56), with a net excess proportion
of 3.7% and 5.5% respectively. One-third (32%) of children diagnosed with fetal
alcohol syndrome had intellectual disability. Interpretation Maternal alcohol use
disorder is the leading known risk factor for intellectual disability with no
identified genetic origin.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith Press

Langue : ANGLAIS