Sex Differences in the Nationwide Incidence of Neurodevelopmental Disorders Among Children in Taiwan
Author(s)
Hsi-Yu Lai, MS1, Lin-Chieh Meng, MS2, Hui-Min Chuang, PharmD, MS1, Fei-Yuan Sharon Hsiao, PhD1.
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, 2Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan, 2Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
OBJECTIVES: Neurodevelopmental disorders (NDDs) are associated with poor mental health and social functioning; however, epidemiological data from Asian populations remain limited. This study aimed to estimate sex-specific incidence rates of NDDs in Taiwan.
METHODS: This population-based study utilized three nationwide databases in Taiwan: the National Birth Certificate Application Database, the National Health Insurance Research Database, and the Maternal and Child Health Database. The cohort included all singleton live births to mothers between January 1, 2004, and December 31, 2015. Follow-up continued until December 31, 2021, to ensure a minimum of 6 years of follow-up. Children were followed for up to 18 years to identify NDDs based on diagnostic codes validated in a claims database. We estimated overall and sex-stratified 8-year cumulative incidence rates of any NDD. Subgroup analyses were also performed by diagnostic category, including autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), learning disabilities (LD), speech or language disorders (SLD), developmental coordination disorders (DCD), intellectual disabilities (ID), and behavioral disorders (BD).
RESULTS: A total of 2,218,204 singleton live births were identified in the study. The overall incidence rate of any NDD was 16.59 per 1,000 person-years (PY) throughout the follow-up period, with a median follow-up duration of 10.63 years (IQR: 7.35-14.41). Males exhibited a higher incidence rate than females (23.04 vs. 10.90 per 1,000 PY). By 8 years of age, the cumulative incidence was 15.43%, with ADHD (7.20%), LD (6.80%), and DCD (3.47%) being the most common diagnoses. Additionally, the 8-year cumulative incidence of any NDD was higher in males compared with females (20.74% vs. 9.65%), and the sex-specific disparity was consistently observed across all NDD subtypes.
CONCLUSIONS: These findings highlight a sex disparity in the incidence of NDD among children. Future research is warranted to investigate sex-specific factors that may contribute to the development of NDDs.
METHODS: This population-based study utilized three nationwide databases in Taiwan: the National Birth Certificate Application Database, the National Health Insurance Research Database, and the Maternal and Child Health Database. The cohort included all singleton live births to mothers between January 1, 2004, and December 31, 2015. Follow-up continued until December 31, 2021, to ensure a minimum of 6 years of follow-up. Children were followed for up to 18 years to identify NDDs based on diagnostic codes validated in a claims database. We estimated overall and sex-stratified 8-year cumulative incidence rates of any NDD. Subgroup analyses were also performed by diagnostic category, including autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), learning disabilities (LD), speech or language disorders (SLD), developmental coordination disorders (DCD), intellectual disabilities (ID), and behavioral disorders (BD).
RESULTS: A total of 2,218,204 singleton live births were identified in the study. The overall incidence rate of any NDD was 16.59 per 1,000 person-years (PY) throughout the follow-up period, with a median follow-up duration of 10.63 years (IQR: 7.35-14.41). Males exhibited a higher incidence rate than females (23.04 vs. 10.90 per 1,000 PY). By 8 years of age, the cumulative incidence was 15.43%, with ADHD (7.20%), LD (6.80%), and DCD (3.47%) being the most common diagnoses. Additionally, the 8-year cumulative incidence of any NDD was higher in males compared with females (20.74% vs. 9.65%), and the sex-specific disparity was consistently observed across all NDD subtypes.
CONCLUSIONS: These findings highlight a sex disparity in the incidence of NDD among children. Future research is warranted to investigate sex-specific factors that may contribute to the development of NDDs.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD79
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Pediatrics