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Dev Med Child Neurol. 2015 Sep;57(9):835-43. doi: 10.1111/dmcn.12746. Epub 2015 Mar 23.

The role of socio-economic status and perinatal factors in racial disparities in the risk of cerebral palsy.

Author information

1
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
2
Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
3
Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
4
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
5
Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA.
6
Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
7
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.

Abstract

AIM:

To determine whether racial disparities in cerebral palsy (CP) risk among US children persist after controlling for socio-economic status (SES) (here indicated by maternal education) and perinatal risk factors.

METHOD:

A population-based birth cohort study was conducted using the Autism and Developmental Disabilities Monitoring Network surveillance and birth data for 8-year-old children residing in multi-county areas in Alabama, Georgia, Missouri, and Wisconsin between 2002 and 2008. The birth cohort comparison group included 458 027 children and the case group included 1570 children with CP, 1202 with available birth records. χ(2) tests were performed to evaluate associations and logistic regression was used to calculate relative risks (RR) and adjusted odds ratios (OR) with 95% confidence intervals (CI).

RESULTS:

The risk of spastic CP was more than 50% higher for black versus white children (RR 1.52, 95% CI 1.33-1.73), and this greater risk persisted after adjustment for SES (OR 1.35, 95% CI 1.18-1.55), but not after further adjustment for preterm birth and size for gestational age. The protective effect of maternal education remained after adjustment for race/ethnicity and perinatal factors.

INTERPRETATION:

Maternal education appears to independently affect CP risk but does not fully explain existing racial disparities in CP prevalence in the US.

PMID:
25808915
PMCID:
PMC4529795
DOI:
10.1111/dmcn.12746
[Indexed for MEDLINE]
Free PMC Article

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