Associations of Birth Defects with Adult Intellectual Performance, Disability and Mortality: Population-based Cohort Study

Abstract

Infants born with birth defects have poorer outcomes in terms of mortality and disability, but the long-term intellectual outcome in children with birth defects is generally unknown. We assessed the long-term associations of various birth defects with mortality and disability, and evaluated whether high mortality and disability were reflected in impaired intellectual performance at age 18. In this nationwide cohort study, records of 9,186 males with and 384,384 without birth defects, registered in the Medical Birth Registry of Norway (1967Norway ( -1979 were linked to the National Conscript Service (1984 -1999). Mortality and disability before military draft, and intelligence test score at conscription were the main outcome measures. Males with birth defects had a relative risk for disability of 6.0 compared with males without defects. Disability was low within categories of birth defects associated with low mortality, and high within defect categories associated with high mortality. The relative risk for not being drafted was highest if maternal educational level was low. Heart defects and cleft palate were the only subgroups in which intellectual performance was lower after adjustment for maternal education, maternal age, marital status and birth order. In particular, intellectual performance was not impaired among those with multiple compared with single defects. We conclude that for the majority of birth defect categories in the present birth cohort, our hypothesis that intellectual performance would be impaired was not confirmed. Thus, there seems to be little reason to fear an adverse intellectual outcome in non-disabled surviving infants with birth defects. (Pediatr Res 59: 848-853, 2006)

Academic Achievement in Individuals with Cleft: A Population-Based Register Study

“…Individuals with cleft had higher odds of receiving the lowest grade and/or reduced odds of receiving high grades among subjects analyzed, along with strong evidence of a lower grade point average in comparison with the population as a whole. This study is congruent with other studies that have identified greater prevalence of cognitive dysfunction and learning difficulties, lower school achievements, and greater use of special education services in individuals with cleft in comparison with individuals without cleft (Broder et al, 1998;Nopoulos et al, 2002;Richman et al, 2005;Eide et al, 2006;Yazdy et al, 2008). Furthermore, this study supports the need to consider cleft type in studies of cognitive and educational outcomes (Richman, 1980;Richman and Eliason, 1984;Richman et al, 1988;Broder et al, 1998), with individuals with CP having the most negative outcome, followed by individuals with CLP, and those with CL being the least affected in comparison with the control group.…”

“…Research has indicated that individuals with cleft can experience cognitive dysfunction, learning difficulties, and lower levels of school achievement (Richman and Eliason, 1982;Broder et al, 1998;Nopoulos et al, 2002;Richman et al, 2005;Eide et al, 2006). Research indicates that these deficiencies can be attributed to the type of cleft (Richman, 1980;Richman andEliason, 1982, 1984;Richman et al, 1988;Broder et al, 1998) or the severity of cleft (McWilliams et al, 1972;Fox et al, 1978;Nopoulos et al, 2002).…”

National population‐based estimates for major birth defects, 2010–2014

“…They remain a major contributor of infant mortality and lifelong disabilities (Centers for Disease Control and Prevention (CDC), National Vital Statistics Report, ; Decoufle, Boyle, Paulozzi, & Lary, ). Compared to children without birth defects, children with birth defects are more likely to experience hospitalizations as well as neurologic and cognitive impairments (Arth et al, ; Decoufle et al, ; Eide, Skjaerven, Irgens, Bjerkedal, & Oyen, ; Petterson, Bourke, Leonard, Jacoby, & Bower, ).…”

Academic Outcomes of Children with Isolated Orofacial Clefts Compared with Children without a Major Birth Defect

“…Children with OFC also have lower achievement and increased special needs in academic settings (Goodstein, 1961; Strauss and Broder, 1993; Broder et al, 1998; Persson et al, 2012; Richman et al, 2012). Intelligence quotient (IQ) studies have shown that children with isolated OFC have lower mean scores than children without OFC, and this trend is apparent at young ages (12–24 months old) and early adulthood (Jocelyn et al, 1996; Eide et al, 2006; Persson et al, 2008). Evaluation of specific cognitive functions shows that the greatest deficit is in verbal IQ, and children with OFC may experience increased reading and language problems (Kommers and Sullivan, 1979; Richman et al, 1988; Collett et al, 2010a; Collett et al, 2010b).…”