Indian Express
6, March 2010
By Neelam Sharma
Chandigarh, India

THE Regional Institute of Mentally Handicapped (RIHM) has found it is in fact home deliveries and prolonged difficult labour in pregnant women which are the leading causes of mental retardation in children below six years of age.

The findings are of random camps and field visits conducted by teams of experts from RIHM in and around the city, especially slum colonies and villages, in which over 580 children were identified for clinical help. The data, collected in 2008, has found while in 32 per cent cases of mental retardation identified in these camps, home delivery was the cause of complications in newborns, in 28 per cent cases, prolonged difficult labour, in the absence of a qualified midwife, was the cause.

Genetic factors, often termed the prominent cause of retardation in children were responsible for only 21 per cent cases only, finds the survey.

As expected, the low birth weight of the baby and the delayed cry at the time of birth were other prominent causes of retardation, the survey has found.

The findings are glaring in the light of the fact that local Health authorities have reiterated that the city has over 75 per cent institutional deliveries, much above the national average which is less than 50 per cent.

As per the RIHM joint director, Dr B S Chavan, the findings are significant as they have pinpointed home deliveries and prolonged difficult labour to be critical causes.

Experts at the institute have also pointed out that the socio–economic status of the families also had a direct correlation with retardation cases in children.

“Although some risk factors, Down’s Syndrome, maternal malnutrition, Low Birth Weight babies, delayed cry at birth are established causes of mental retardation, we found a large percentage could be attributed to home deliveries (32%) and prolonged difficult labour (28%). Another striking finding was that 82% of the cases diagnosed as having mental retardation were from a low socio–economic status that is Below Poverty Line and among these, 42% were the ones living in a large family,” said a senior paediatrician involved with the study.

While the institute identified over 500 such children, the findings are based on analysis of 100 such random cases.

ACTORS LEADING O RETARDATION netic causes: 21% tal Causes re–term: 12% Post–term: 7% Difficult Labour: 28% Home deliveries: 32% st–natal causes ow birth weight: 41% Delayed cry: 47% Neonatal jaundice requiring ototherapy: 17% ) Neonatal jaundice requir exchange transfusion: 1% Neonatal seizures: 17%