Prenatal and postnatal risk factors for mental retardation among children in Bangladesh

This study evaluated the contribution of prenatal, perinatal, neonatal, and postnatal factors to the prevalence of cognitive disabilities among childr en aged 2-9 years in Bangladesh. A two-phase survey was implemented in 1987 -1988 in which 10,299 children were screened for disability. In multivariat e analyses, significant independent predictors of serious mental retardatio n in rural and urban areas included maternal goiter (rural odds ratio (OR) = 5.14, 95% confidence interval (CI): 1.23, 21.57; urban OR = 4.82, 95% CI: 2.73, 8.50) and postnatal brain infections (rural OR = 29.24, 95% CI: 7.17 , 119.18; urban OR = 13.65, 95% CI: 4.69, 39.76). In rural areas, consangui nity (OR = 15.13, 95% CI: 3.08, 74.30) and landless agriculture (OR = 6.02, 95% CI: 1.16, 31.19) were also independently associated with the prevalenc e of serious mental retardation. In both rural and urban areas, independent risk factors for mild cognitive disabilities included maternal illiteracy (OR = 2.48, 95% CI: 0.86, 7.12), landlessness (OR = 4.27, 95% GI: 1.77, 10. 29), maternal history of pregnancy loss (OR = 2.61, 95% CI: 0.95, 7.12), an d small for gestational age at birth (OR = 3.86, 95% CI: 1.56, 9.55). Inter ventions likely to have the greatest impact on preventing cognitive disabil ities among children in Bangladesh include expansion of existing iodine sup plementation, maternal literacy, and poverty alleviation programs as well a s prevention of intracranial infections and their consequences. Further pop ulation-based studies are needed to confirm and understand the association between consanguinity and serious cognitive disability.