ArticlePloS one2014
Risk of cerebral palsy among the offspring of immigrants.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Global prevalence of cerebral palsy: A systematic analysis.Developmental medicine and child neurology · 2022Pooled it
- Adverse Pregnancy Outcomes and International Immigration Status: A Systematic Review and Meta-analysis.Annals of global health · 2022Pooled it
- Rate differences in referrals and diagnostic outcomes of neurodevelopmental disorders between children with native and migrant backgrounds: a retrospective cohort study.European child & adolescent psychiatry · 2025Article
- Cerebral palsy and perinatal mortality in children born in Norway to immigrant mothers.Developmental medicine and child neurology · 2025Article
- Neighborhood Income Mobility and Risk of Neonatal and Maternal Morbidity.JAMA network open · 2023Article
- Severe Maternal Morbidity and Mortality Among Immigrant and Canadian-Born Women Residing Within Low-Income Neighborhoods in Ontario, Canada.JAMA network open · 2023Article
- Cerebral palsy in Canada, 2011-2031: results of a microsimulation modelling study of epidemiological and cost impacts.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2020Article
- Article
- Intergenerational abortion tendency between mothers and teenage daughters: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Article
- Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis.BMJ open · 2016Article
- Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan.PloS one · 2016Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCerebral palsy (CP) has a multifactorial etiology, and placental vascular disease may be one major risk factor. The risk of placental vascular disease may be lower among some immigrant groups. We studied the association between immigrant status and the risk of CP.
methodsWe conducted a population-based retrospective cohort study of all singleton and twin livebirths in Ontario between 2002-2008, and who survived ≥28 days after birth. Each child was assessed for CP up to age 4 years, based on either a single inpatient or ≥2 outpatient pediatric diagnoses of CP. Relative to non-immigrants (n = 566,668), the risk of CP was assessed for all immigrants (n = 177,390), and further evaluated by World region of origin. Cox proportional hazard ratios (aHR) were adjusted for maternal age, income, diabetes mellitus, obesity, tobacco use, Caesarean delivery, year of delivery, physician visits, twin pregnancy, preterm delivery, as well as small- and large-for-gestational age birthweight.
resultsThere were 1346 cases of CP, with a lower rate among immigrants (1.45 per 1000) than non-immigrants (1.92 per 1000) (aHR 0.77, 95% confidence interval [CI] 0.67 to 0.88). Mothers from East Asia and the Pacific (aHR 0.54, 95% CI 0.39 to 0.77) and the Caribbean (aHR 0.58, 95% CI 0.37 to 0.93) were at a significantly lower risk of having a child with CP. Whether further adjusting for preeclampsia, gestational hypertension, placental abruption or placental infraction, or upon using a competing risk analysis that further accounted for stillbirth and neonatal death, these results did not change.
conclusionsImmigration and ethnicity appear to attenuate the risk of CP, and this effect is not fully explained by known risk factors.
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