title: The risk of intellectual disability in children born to mothers with preeclampsia or eclampsia with partial mediation by low birth weight.
abstract: OBJECTIVE
  Preeclampsia and eclampsia (PE) are potentially modifiable risk factors for maternofetal complications. Owing to a paucity of research connecting PE to the risk of intellectual disability (ID) in the offspring, this study examined this relationship. Furthermore, we explored how low birth weight (LBW) mediates the effect of PE on ID.
  
  
  METHODS
  Data related to South Carolina Medicaid births from 1996 to 2002 were comprised of linked data from maternal Medicaid records, delivery records, birth certificates, Department of Education (DOE), and the Department of Disabilities and Special Needs (DDSNs). After exclusions such as nonidiopathic etiologies of ID, multiple gestations, subsequent siblings in the cohort, pregnancy losses, births under 20 weeks' gestation, and children neither in DOE nor DDSN records, 80,866 maternal-child dyads remained. After adjusting for five covariates of maternal age, race, and education as well as the child's birth year and sex, the effect of PE on ID was examined.
  
  
  RESULTS
  The rates of PE and ID were 6.4 and 2.0%, respectively. The rates of ID among children exposed and not exposed to PE were 3.0 and 2.0%, respectively. The crude odds ratio (OR) was 1.549 (95% CI 1.310, 1.832) and the adjusted OR was 1.58 (95% CI 1.334, 1.870). LBW was a significant mediator of the relationship accounting for approximately half of the association.
  
  
  CONCLUSIONS
  Because of the association of PE, ID, and LBW, additional research is needed to explain mechanisms and to investigate possible impacts of different PE treatment.
authors.affiliation: Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC, USA. margaretgriffithmdmph@yahoo.com
authors.forename: Margaret Irene
authors.initials: MI
authors.lastname: Griffith
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.forename: Suzanne
authors.initials: S
authors.lastname: McDermott
mesh_terms: D000328:Adult; D004461:Eclampsia; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000209:etiology*; D011225:Pre-Eclampsia; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors