The role of socio-economic status and perinatal factors in racial disparities in the risk of cerebral palsy.
The role of socio-economic status and perinatal factors in racial disparities in the risk of cerebral palsy.
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DOI：
10.1111/dmcn.12746
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发表时间：
2015-09
影响因子：
3.8
通讯作者：
Yeargin-Allsopp M
中科院分区：
文献类型：
--
作者：
Durkin MS;Maenner MJ;Benedict RE;Van Naarden Braun K;Christensen D;Kirby RS;Wingate M;Yeargin-Allsopp M
确定在控制了社会经济地位（SES）（此处由母亲教育程度表示）和围产期风险因素后，美国儿童中脑瘫（CP）风险的种族差异是否持续存在。利用自闭症和发育障碍监测网络的监测和出生数据，对2002年至2008年期间居住在亚拉巴马、格鲁吉亚、密苏里州和威斯康星州多个县的8岁儿童进行了一项基于人群的出生队列研究。出生队列对照组包括458027名儿童，病例组包括1570名CP儿童，1202名有出生记录。采用χ2检验评估相关性，并使用logistic回归计算相对危险度（RR）和校正比值比（OR）及其95%置信区间（CI）。黑人儿童痉挛性脑瘫的风险比白色儿童高50%以上（RR 1.52，95% CI 1.33-1.73），在调整SES后，这种过度风险仍然存在（OR 1.35，95% CI 1.18-1.55），但在进一步调整早产和胎龄大小后，这种过度风险不再存在。在调整种族/民族和围产期因素后，母亲教育的保护作用仍然存在。母亲教育似乎独立影响CP风险，但不能完全解释美国CP患病率的种族差异。
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. 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. χ2 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). 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 excess 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. Maternal education appears to independently affect CP risk but does not fully explain existing racial disparities in CP prevalence in the US.