{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T13:16:40Z","timestamp":1775308600964,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T00:00:00Z","timestamp":1613174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100014857","name":"National Natural Science Foundation of China-Guangdong Joint Fund","doi-asserted-by":"publisher","award":["82073570"],"award-info":[{"award-number":["82073570"]}],"id":[{"id":"10.13039\/501100014857","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the association between a maternal history of spontaneous abortion and intellectual disability in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This cohort study included 1\u00a0778\u00a0786 children (913 340 males, 865 085 females, 361 missing data; mean age 15y 2mo, SD 8y 11mo, range birth to 40y) born in Denmark between 1977 and 2016. Cox proportional hazard regression was used to estimate the hazard ratios (HRs) of intellectual disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall HR of intellectual disability for children with a maternal history of spontaneous abortion was 1.17 (95% confidence interval [CI] 1.12\u20131.22) and the risk for multiple spontaneous abortions (HR=1.30, 95% CI 1.20\u20131.40) was higher than for a single spontaneous abortion (HR=1.13, 95% CI 1.07\u20131.18). When only cases of inpatient intellectual disability were included, the estimates increased slightly: the overall HR was 1.22 (95% CI 1.12\u20131.32), the HR for multiple spontaneous abortions was 1.37 (95% CI 1.20\u20131.58), and the HR for a single spontaneous abortion was 1.17 (95% CI 1.07\u20131.28). The risks were similar regardless of whether spontaneous abortion occurred before or after the index delivery. Estimates were nearly unchanged after adjusting for preterm birth, low birthweight, or Apgar score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Children born to mothers with spontaneous abortion, especially multiple spontaneous abortions, may be at a higher risk of intellectual disability in later life, regardless of whether spontaneous abortion occurred before or after the index delivery. The findings have clinical implications for targeted early intervention of children with intellectual disability.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>What this paper adds<\/jats:title><\/jats:caption><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>A maternal history of spontaneous abortion was associated with a risk of intellectual disability in offspring.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The risk was higher in children whose mothers previously had multiple spontaneous abortions.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Similar risks were observed regardless of whether spontaneous abortion occurred before or after childbirth.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:boxed-text>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14839","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T16:24:54Z","timestamp":1613319894000},"page":"831-838","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk of intellectual disability and maternal history of spontaneous abortion: a nationwide cohort study"],"prefix":"10.1111","volume":"63","author":[{"given":"Honglei","family":"Ji","sequence":"first","affiliation":[{"name":"NHC Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research) School of Public Health Fudan University Shanghai China"},{"name":"Department of Maternal, Child and Adolescent Health School of Public Health and Global Health Institute Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongfu","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health and Key Laboratory of Public Health Safety of Ministry of Education Fudan University Shanghai China"},{"name":"Department of Clinical Medicine \u2010 Department of Clinical Epidemiology Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1509-2035","authenticated-orcid":false,"given":"Maohua","family":"Miao","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research) School of Public Health Fudan University Shanghai China"},{"name":"Department of Clinical Medicine \u2010 Department of Clinical Epidemiology Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Maternal, Child and Adolescent Health School of Public Health and Global Health Institute Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yuan","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research) School of Public Health Fudan University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Lin","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Embryo Original Diseases The International Peace Maternity &amp; 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