Objective To investigate the associations between maternal pregnancy-related factors and the clinical severity of intellectual developmental disorder/global developmental delay (IDD/GDD) in children, in order to provide evidence for risk stratification and early intervention. Methods A total of 275 children with IDD/GDD who were treated at Xi′an Encephalopathy Hospital of Traditional Chinese Medicine between October 2022 and March 2025 were included.Developmental quotient (DQ) or full-scale intelligence quotient (FSIQ) was assessed using the Gesell Developmental Schedule or the Wechsler Intelligence Scale for Children, Fourth Edition, respectively.Social adaptive functioning was evaluated usingthe Normal Development of Social Skills from Infancy to Junior High School Children.According to medical history,clinical manifestations, and standardized assessments, the children were categorized into mild (n=87), moderate (n=77), and severe (n=111) groups.Variables identified by univariate analysis were entered into a multinomial logistic regression model to examine their associations with IDD/GDD severity, with the severe group as the reference category. Results Univariate analysis showed significant differences in advanced maternal age, maternal iron-deficiency anemia (IDA), electromagnetic-field exposure for >10 h/d during pregnancy and respiratory viral infection during early pregnancy among three groups (P<0.05).In multionmial logistic regression analyses,maternal IDA was associated with severe IDD/GDD in children (OR=2.310, 95%CI: 1.123 - 4.752,P<0.05).EPRVI (moderate: OR=2.338, 95%CI: 1.009 - 5.419; severe: OR=3.387, 95%CI:1.590 - 7.214) and prenatal electromagnetic field exposure >10 h/day (moderate:OR=3.227,95%CI:1.174 - 8.873;severe:OR=2.788,95%CI:1.032 - 7.531)were associated with higher severity levels of IDD/GDD (P<0.05).Advanced maternal age was associated with moderate IDD/GDD (OR=2.891, 95%CI: 1.084 - 7.705,P<0.05). Conclusions Maternal IDA and respiratory viral infection during early pregnancy are independently associated with severe IDD/GDD, suggesting that prenatal iron deficiency and maternal immune activation may contribute to variation in disease severity.Enhanced monitoring of maternal iron status and prevention of infection during early pregnancy may be warranted.
Key words
intellectual developmental disorder /
global developmental delay /
pregnancy /
iron-deficiency anemia /
respiratory viral infection
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