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Dev Med Child Neurol. 2019 May;61(5):586-592. doi: 10.1111/dmcn.14026. Epub 2018 Sep 17.

Impact of social disadvantage on cerebral palsy severity.

Author information

1
Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, NSW, Australia.
2
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
3
Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.
4
Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
5
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
6
Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
7
Queensland Cerebral Palsy Register, CPL - Choice, Passion, Life, Brisbane, QLD, Australia.
8
The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia.

Abstract

in English, Portuguese, Spanish

AIM:

To investigate the impact of socio-economic disadvantage on indicators of cerebral palsy (CP) severity - motor impairment, intellectual disability, and the presence of severe comorbidities - in children with CP in Australia.

METHOD:

Data from the Australian Cerebral Palsy Register were analysed. Socio-economic disadvantage was assessed using maternal age, maternal country of birth, and a measure of neighbourhood socio-economic status (SES) at the time of the child's birth. Descriptive bivariate analysis, trend analysis, risk ratios, and mediation analysis were undertaken to examine the impact of disadvantage on the indicators of CP severity.

RESULTS:

A socio-economic gradient was demonstrated with an increasing proportion of children with non-ambulant status, at least moderate intellectual disability, and the presence of severe comorbidities (having epilepsy, functional blindness, bilateral deafness, and/or no verbal communication) with decreasing neighbourhood SES, adolescent motherhood, and maternal minority ethnicity.

INTERPRETATION:

In Australia, socio-economic disadvantage at birth impacts adversely on CP severity at age 5 years. By identifying that socio-economically disadvantaged children with CP are at greater risk of more severe functional outcomes, we can inform targeted interventions at the family and neighbourhood level to reduce these inequities for children with CP.

WHAT THIS PAPER ADDS:

Socio-economic disadvantage is associated with increased severity of cerebral palsy functional outcomes. This encompasses low neighbourhood socio-economic status, adolescent motherhood, and maternal minority ethnicity.

PMID:
30221759
DOI:
10.1111/dmcn.14026
[Indexed for MEDLINE]

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