Population Health Sciences, University of Bristol, Bristol, UK
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
BMJ Glob Health. 2021 Mar;6(3). doi: 10.1136/bmjgh-2020-003734.
The long-term consequences of parental emigration on offspring self-harm risk is unknown.
We investigated the association between experiencing parental emigration in childhood with hospital presentations for self-poisoning in adulthood using a hospital case-control study. Cases were adult self-poisoning patients (≥18 year olds) admitted to the medical toxicology ward Teaching Hospital Peradeniya, Sri Lanka. Sex and age frequency matched controls were recruited from the outpatient department or nearby specialist clinics at the same hospital. Details of parental emigration were collected using a pre-piloted questionnaire. The relationship between parental emigration and self-poisoning in adulthood was estimated using logistic regression models.
298 cases, and 500 hospital controls were interviewed for the study. We estimate that one in five adults experienced parental emmigration as children (95% CI 17% to 24%). We find limited evidence that children from households with emigrating parents were more likely to experience adverse childhood experiences than those with non-emigrating parents. We found no statistical evidence of an increased risk of self-poisoning in adulthood in individuals who experienced parental emigration (maternal or paternal) during childhood. There was no statistical evidence that the impact differed by the sex of the participant.
Adults who experienced parental emigration as children were no more likely to self-poison than adults with non-emigrating parents. Further research using longitudinal data are needed to understand whether any adverse outcomes observed in 'left-behind' children are a consequence of parental emigration or due to factors associated but predate the emigration. Prospective data are also important to investigate whether there are any lasting effects on children who experience parental emigration.
父母移民对子女自残风险的长期后果尚不清楚。
我们采用医院病例对照研究，调查了儿童时期经历父母移民与成年后因自我伤害而住院之间的关联。病例为成年自我伤害患者（≥18 岁），收治于斯里兰卡佩拉德尼亚教学医院的医疗毒理学病房。通过同一家医院的门诊或附近专科诊所招募性别和年龄频数匹配的对照。使用预先制定的问卷收集有关父母移民的详细信息。使用逻辑回归模型估计父母移民与成年后自我伤害之间的关系。
对 298 例病例和 500 例医院对照进行了访谈。我们估计，五分之一的成年人在儿童时期经历过父母移民（95%CI 17%至 24%）。我们发现，有少量证据表明，来自有移民父母的家庭的儿童比没有移民父母的儿童更有可能经历不良的童年经历。我们没有发现有统计学意义的证据表明，在儿童时期经历过父母移民（母亲或父亲）的个体成年后自我伤害的风险增加。没有统计学证据表明，参与者的性别对这种影响有差异。
作为儿童时期经历过父母移民的成年人，自我伤害的可能性并不高于没有移民父母的成年人。需要使用纵向数据进行进一步研究，以了解在“留守”儿童中观察到的任何不良后果是父母移民的结果还是与移民前相关但提前发生的因素的结果。前瞻性数据也很重要，可用于调查经历父母移民的儿童是否存在任何持久影响。
