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Cerebral palsy in Canadian Indigenous children
Author(s) -
Chen Anjellica,
Dyck Holzinger Sasha,
Oskoui Maryam,
Shevell Michael
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14776
Subject(s) - cerebral palsy , gross motor skill , odds ratio , indigenous , medicine , confidence interval , pediatrics , gross motor function classification system , demography , motor skill , physical therapy , psychiatry , biology , ecology , sociology
Aim To determine whether inequities in health outcomes for Indigenous Canadians are also present in cerebral palsy (CP) by comparing CP profiles between Indigenous and non‐Indigenous children. Method Using the Canadian Cerebral Palsy Registry, we conducted a cross‐sectional study. CP motor subtype, gross motor severity, comorbidities, perinatal adversity, preterm birth, and parental education were compared between 94 Indigenous (53 males, 41 females) and 1555 non‐Indigenous (891 males, 664 females) children (all >5y). Multivariate analysis was done to analyze adverse CP factors, defined as CP gross motor severity and comorbidities. CP etiologies, either prenatal/perinatal or postnatal, were also compared. Results Indigenous children with CP have higher odds of having low parental education (odds ratio [OR] 6.15, 95% confidence interval [CI] 3.36–11.3) and comorbidities (OR 4.46, 95% CI 1.62–12.3), especially cognitive (OR 4.52, 95% CI 2.27–9.05), communication (OR 2.66, 95% CI 1.54–4.61), and feeding (OR 2.25, 95% CI 1.33–3.83) impairment. Indigenous children also have higher CP gross motor severity ( p =0.03). Indigenous children are also more likely to have non‐accidental head injury ( n =4; OR 8.18, 95% CI 1.86–36.0) as the cause of their postnatal CP. Interpretation Indigenous populations have worse health outcomes as a result of intergenerational impacts of colonization. Our study shows that Indigenous children with CP have increased comorbidities and higher CP gross motor severity, reinforcing the need for a multidisciplinary approach to management. Furthermore, targeted prevention programs against preventable causes of CP, such as non‐accidental head injury, may be beneficial. What this paper adds Indigenous children with cerebral palsy (CP) have more severe motor impairment and more comorbidities. Non‐accidental head injury is a significant cause of postnatal CP.