Cerebral palsy among children of immigrants in Denmark and the role of socioeconomic status.
Cerebral palsy
Cohort
Ethnic disparities
Immigrants
Risk factors
Journal
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
ISSN: 1532-2130
Titre abrégé: Eur J Paediatr Neurol
Pays: England
ID NLM: 9715169
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
07
10
2018
revised:
16
01
2019
accepted:
29
01
2019
pubmed:
20
2
2019
medline:
17
7
2019
entrez:
20
2
2019
Statut:
ppublish
Résumé
Children of immigrants in Denmark have excess risk for some of the most well-established risk factors for cerebral palsy (CP). To study differences in risk of CP between children of immigrants and children of Danish-born mothers, and explore whether socioeconomic status drives any potential association. A register-based cohort study including 1,274,616 children born in Denmark between 1981 and 2007. Of these, 2807 had a validated CP diagnosis in the Danish CP Register. We estimated the risk of CP as odds ratios (OR) using logistic regression and assessed mediation through socioeconomic status using natural effect models. In children of Danish-born mothers, 2.2/1000 had CP overall and the prevalence was similar for children of immigrants. However, children of immigrants had lower risk of unilateral spastic CP than children of Danish native-born mothers; OR = 0.59 (95% CI:0.38-0.91) for Western and OR = 0.79 (95% CI:0.61-1.03) for Non-Western immigrants. By contrast, the risk of bilateral spastic CP was higher in children of Non-Western immigrants (OR = 1.27 (95% CI:1.05-1.53)), especially from Turkey and Pakistan compared with children of Danish native-born mothers. The mediation analysis revealed an indirect effect (through maternal educational level and household income) with an OR of 1.06 (95% CI:0.99-1.14) for children of Non-Western immigrants. While children of immigrants had lower risk of unilateral spastic CP than children of Danish-born mothers, the risk of bilateral spastic CP was increased in children of Non-Western immigrants. Socioeconomic status did not appear to be a significant contributor to the increased risk of bilateral spastic CP.
Sections du résumé
BACKGROUND
BACKGROUND
Children of immigrants in Denmark have excess risk for some of the most well-established risk factors for cerebral palsy (CP).
OBJECTIVES
OBJECTIVE
To study differences in risk of CP between children of immigrants and children of Danish-born mothers, and explore whether socioeconomic status drives any potential association.
METHODS
METHODS
A register-based cohort study including 1,274,616 children born in Denmark between 1981 and 2007. Of these, 2807 had a validated CP diagnosis in the Danish CP Register. We estimated the risk of CP as odds ratios (OR) using logistic regression and assessed mediation through socioeconomic status using natural effect models.
RESULTS
RESULTS
In children of Danish-born mothers, 2.2/1000 had CP overall and the prevalence was similar for children of immigrants. However, children of immigrants had lower risk of unilateral spastic CP than children of Danish native-born mothers; OR = 0.59 (95% CI:0.38-0.91) for Western and OR = 0.79 (95% CI:0.61-1.03) for Non-Western immigrants. By contrast, the risk of bilateral spastic CP was higher in children of Non-Western immigrants (OR = 1.27 (95% CI:1.05-1.53)), especially from Turkey and Pakistan compared with children of Danish native-born mothers. The mediation analysis revealed an indirect effect (through maternal educational level and household income) with an OR of 1.06 (95% CI:0.99-1.14) for children of Non-Western immigrants.
CONCLUSIONS
CONCLUSIONS
While children of immigrants had lower risk of unilateral spastic CP than children of Danish-born mothers, the risk of bilateral spastic CP was increased in children of Non-Western immigrants. Socioeconomic status did not appear to be a significant contributor to the increased risk of bilateral spastic CP.
Identifiants
pubmed: 30777617
pii: S1090-3798(18)30455-0
doi: 10.1016/j.ejpn.2019.01.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
507-516Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.