title: Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small for gestational age.
abstract: OBJECTIVE
  To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden.
  
  
  METHODS
  Population-based register study.
  
  
  METHODS
  National registers; the National Patient Register linked to the Medical Birth Register.
  
  
  METHODS
  Children of first-time mothers with ID (n = 326; classified in the International Classification of Diseases 8-10) were identified and compared with 340 624 children of first-time mothers without ID or any other psychiatric diagnosis between 1999 and 2007.
  
  
  METHODS
  Population-based data were extracted from the National Patient Register and the Medical Birth Register.
  
  
  METHODS
  Mode of birth, preterm birth, small for gestational age, Apgar score, stillbirth and perinatal death.
  
  
  RESULTS
  Children born to mothers with ID were more often stillborn (1.2 vs. 0.3%) or died perinatally (1.8 vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5 vs. 17.7%) and preterm birth (12.2 vs. 6.1%), were small for gestational age (8.4 vs. 3.1%) and had lower Apgar scores (<7 points at five minutes; 3.7 vs 1.5%) compared with children born to mothers without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small for gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID.
  
  
  CONCLUSIONS
  Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. berit.hoglund@kbh.uu.se
authors.forename: Berit
authors.initials: B
authors.lastname: Höglund
authors.forename: Peter
authors.initials: P
authors.lastname: Lindgren
authors.forename: Margareta
authors.initials: M
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008607:Intellectual Disability; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology