Department of Public Health at University of Copenhagen, Oesterfarimagsgade 5, Postboks 2099, 1014 Copenhagen, Denmark.
Department of Global Public Health and Primary Care at University of Bergen, Postboks 7804, N-5020 Bergen, Norway; Department of Pediatrics at Haukeland University Hospital, Post Office Box 1400, N-5021 Bergen, Norway.
Eur J Paediatr Neurol. 2019 May;23(3):507-516. doi: 10.1016/j.ejpn.2019.01.007. Epub 2019 Feb 4.
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.
丹麦移民子女患脑瘫（CP）的一些公认风险因素的风险过高。
研究移民子女与丹麦出生母亲子女的 CP 风险差异，并探讨社会经济地位是否会影响任何潜在关联。
这是一项基于登记的队列研究，纳入了 1981 年至 2007 年期间在丹麦出生的 1274616 名儿童。其中，有 2807 名儿童在丹麦 CP 登记处确诊为 CP。我们使用逻辑回归估计 CP 的风险比（OR），并使用自然效应模型评估社会经济地位的中介作用。
在丹麦出生的母亲所生的儿童中，总体上有 2.2/1000 患有 CP，移民子女的患病率相似。然而，与丹麦本土出生母亲的子女相比，移民子女患单侧痉挛性 CP 的风险较低；西方移民的 OR=0.59（95%CI：0.38-0.91），非西方移民的 OR=0.79（95%CI：0.61-1.03）。相比之下，非西方移民子女患双侧痉挛性 CP 的风险更高（OR=1.27（95%CI：1.05-1.53）），尤其是来自土耳其和巴基斯坦的移民子女与丹麦本土出生母亲的子女相比。中介分析显示，非西方移民子女的间接效应（通过母亲的教育水平和家庭收入）的 OR 为 1.06（95%CI：0.99-1.14）。
虽然移民子女患单侧痉挛性 CP 的风险低于丹麦出生母亲的子女，但非西方移民子女患双侧痉挛性 CP 的风险增加。社会经济地位似乎不是双侧痉挛性 CP 风险增加的重要因素。
