Dev Med Child Neurol. 2026 Apr 5. doi: 10.1111/dmcn.70243. Online ahead of print.
ABSTRACT
AIM: To investigate the association between socioeconomic status and cerebral palsy (CP) motor function, adjusting for known clinical and candidate environmental risk factors, that is, air pollution and distance to a children’s treatment center (CTC).
METHOD: This cross-sectional study examined data from CP-NET, a database of children with CP from Ontario, Canada. To estimate the association of socioeconomic status represented by deprivation quintiles and CP motor function (Gross Motor Function Classification System [GMFCS] level), we fitted an ordinal logistic regression adjusted for gestational age, birthweight for gestational age, maternal illness, distance to a CTC, and the pollution indicators nitrogen dioxide and fine particulate matter with a diameter of 2.5 μm or less.
RESULTS: The final cohort (n = 292; 126 females, 166 males) were functioning in GMFCS levels I to III (n = 217, 74.3%) and GMFCS levels IV and V (n = 75, 25.7%) and were aged 2 to 7 years. A greater proportion of children classified in GMFCS levels IV or V were found in higher material deprivation quintiles with a dose-response (higher deprivation levels associated with increased motor impairment) (odds ratio = 2.85 [95% confidence interval = 1.25-6.65]; p = 0.025). Distance to a CTC was associated with greater CP motor impairment (odds ratio = 1.70 [95% confidence interval = 1.20-2.51]; p = 0.003), while air pollution showed no association.
INTERPRETATION: Higher levels of deprivation and distance to a CTC were associated with greater CP motor impairment. Further identification of modifiable risk factors can guide advocacy for reducing social inequalities for individuals with CP.
PMID:41936126 | DOI:10.1111/dmcn.70243
