Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Department of Clinical Neuroscience, Division of Neurology, Karolinska Institutet Huddinge, Stockholm, Sweden.
Eur J Neurol. 2020 Jan;27(1):152-159. doi: 10.1111/ene.14049. Epub 2019 Aug 19.
Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden.
The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data from the Total Population Register.
A total of 26 310 individuals had a registered epilepsy event, i.e. 6.5/1000 (6.6/1000 amongst boys and 6.3/1000 amongst girls). After adjustment, the risk of epilepsy was lower than in children of Swedish-born parents. Amongst girls the significant HR was 0.85 (95% CI 0.81-0.88), but in boys only when adjusting also for comorbidity (HR 0.96, 95% CI 0.92-0.99). Amongst specific immigrant groups, a higher incidence of epilepsy was observed amongst boys with parents from Turkey and Africa, but not when adjusting for comorbidity, and a lower risk was observed in many other groups (boys with parents from Latvia, girls with parents from Finland, Iceland, Southern Europe, countries from the former Yugoslavia, and Asia).
The risk of epilepsy was lower in second-generation immigrant children compared to children with Swedish-born parents, but with substantial differences between different immigrant groups.
本研究旨在探讨出生国与瑞典第二代移民癫痫发病的相关性。
研究人群包括瑞典所有年龄在 18 岁以下的儿童（n=4023149）。癫痫的定义为国家患者登记处至少有一次癫痫诊断记录。采用 Cox 回归，以瑞典出生父母的个体为参照，评估癫痫发病率，以危险比（HR）和 95%置信区间（95%CI）表示。所有模型均按性别分层，并根据年龄、在瑞典的地理居住情况、教育水平、婚姻状况、邻里社会经济地位和合并症进行调整，同时使用总人口登记处的数据。
共有 26310 例个体发生癫痫事件，即 6.5/1000（男孩为 6.6/1000，女孩为 6.3/1000）。调整后，癫痫风险低于瑞典出生父母的子女。女孩的显著 HR 为 0.85（95%CI 0.81-0.88），但仅在调整合并症时男孩才有此结果（HR 0.96，95%CI 0.92-0.99）。在特定移民群体中，来自土耳其和非洲的父母的男孩癫痫发病率较高，但调整合并症后则无此结果，而许多其他群体的癫痫发病率较低（来自拉脱维亚的男孩，来自芬兰、冰岛、南欧、前南斯拉夫国家和亚洲的女孩）。
与瑞典出生父母的子女相比，第二代移民儿童癫痫发病风险较低，但不同移民群体之间存在显著差异。
