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Published on: January 11, 2016
Cerebral palsy and socioeconomic status: a retrospective cohort study
R Sundrum1, S Logan, A Wallace
1Ealing Primary Care Trust, 92 Bath Road, Hounslow, London TW3 3EL, UK. ratna.Sundrum@ealingpct.nhs.uk
Insights
Children from lower socioeconomic status (SES) have a higher risk of cerebral palsy. This inequality in risk is partly explained by factors like birth weight and gestational age.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Cerebral palsy (CP) is a significant developmental disorder.
- Socioeconomic status (SES) is a known determinant of health outcomes.
- Understanding the link between SES and CP risk is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between socioeconomic status and the risk of developing cerebral palsy.
- To quantify the extent to which SES inequality contributes to cerebral palsy cases.
Main Methods:
- Retrospective cohort study of 105,760 live births in West Sussex (1982-1997).
- Identified 293 children diagnosed with cerebral palsy.
- Assessed SES using Registrar General's Social Class (RGSC) and Townsend Deprivation Index (TDI) based on enumeration districts (EDs).
Main Results:
- A linear association was found between lower SES and increased cerebral palsy risk.
- SES inequality was statistically "attributable" to 51% (RGSC) and 30% (ED quintiles) of CP cases.
- The association persisted in logistic regression models, even after adjusting for birth weight and gestational age.
Conclusions:
- A strong link exists between socioeconomic status and cerebral palsy risk.
- Known social gradients in birth weight and gestational age only partially explain this association.
- Further research into other contributing socioeconomic factors is warranted.
Aims:
To study the relation between risk of cerebral palsy and socioeconomic status.
Methods:
A total of 293 children with a diagnosis of cerebral palsy out of 105,760 live births between 1 January 1982 and 31 December 1997 were identified from the special conditions sub-file of the West Sussex Computerised Child Health System.
Results:
There was a linear association between risk of cerebral palsy and socioeconomic status (SES) measured by the Registrar General's social class (RGSC) and enumeration district (ED) ranked into quintiles by the Townsend Deprivation Index derived from 1991 census data. Fifty one per cent and 30% of cases of cerebral palsy were statistically "attributable" to inequality in SES using the RGSC and ED quintile respectively. A linear association was also noted for singleton live births. The association between risk of cerebral palsy and ED quintile persisted in a logistic regression model that included birth weight and gestational age, although that between RGSC and cerebral palsy no longer reached conventional levels of statistical significance after adjustment.
Conclusions:
A strong association was observed between socioeconomic status and the risk of cerebral palsy, which was only partly accounted for by the known social gradients in birth weight and gestational age.
