The role of perinatal brain damage in developmental disabilities: An epidemiologic perspective
✍ Scribed by Dammann, Olaf ;Leviton, Alan
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 81 KB
- Volume
- 3
- Category
- Article
- ISSN
- 1080-4013
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✦ Synopsis
To examine the potential contribution of epidemiologic research to the identification of perinatal brain damage as a ''cause'' of developmental disabilities, the authors review definitions and methods used in this field. The current literature provides considerably different estimates of the population prevalence of mental retardation (3-40 per thousand), cerebral palsy (1.2-2.6 per thousand), and learning disabilities (33-65 per thousand). Furthermore, the presumable proportion of disabilities caused in the perinatal period also differs with the population under investigation, age at examination, and exposure and outcome definition. Approximately 8-43% of cerebral palsy and 10-25% of mental retardation may be associated with variables describing perinatal morbidity usually interpreted as indicators of brain damage. The authors discuss the recent literature on the association of developmental disabilities and proxy variables, e.g., abnormal neuroimaging results, so-called asphyxia, abnormal fetal heart rate patterns or thyroxine levels, and severity of illness scores. Exact definitions of exposure and outcome, a proper study design, and agreement of findings from multiple studies are needed before associations between perinatal brain damage and developmental disabilities should be accepted as causal.