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Epilepsy in second-generation immigrants : a cohort study of all children up to 18 years of age in Sweden

Wändell, P.; Fredrikson, S.; Carlsson, A. C.; Li, X. LU ; Gasevic, D.; Sundquist, J. LU and Sundquist, K. LU (2019) In European Journal of Neurology
Abstract

Background and purpose: Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden. Methods: The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data... (More)

Background and purpose: Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden. Methods: The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data from the Total Population Register. Results: A total of 26 310 individuals had a registered epilepsy event, i.e. 6.5/1000 (6.6/1000 amongst boys and 6.3/1000 amongst girls). After adjustment, the risk of epilepsy was lower than in children of Swedish-born parents. Amongst girls the significant HR was 0.85 (95% CI 0.81–0.88), but in boys only when adjusting also for comorbidity (HR 0.96, 95% CI 0.92–0.99). Amongst specific immigrant groups, a higher incidence of epilepsy was observed amongst boys with parents from Turkey and Africa, but not when adjusting for comorbidity, and a lower risk was observed in many other groups (boys with parents from Latvia, girls with parents from Finland, Iceland, Southern Europe, countries from the former Yugoslavia, and Asia). Conclusion: The risk of epilepsy was lower in second-generation immigrant children compared to children with Swedish-born parents, but with substantial differences between different immigrant groups.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
epilepsy, gender, incidence, second-generation immigrants, socioeconomic status
in
European Journal of Neurology
publisher
Wiley-Blackwell
external identifiers
  • scopus:85070804155
ISSN
1351-5101
DOI
10.1111/ene.14049
language
English
LU publication?
yes
id
16908ef0-a9b1-4912-b79a-f18942bc1ce4
date added to LUP
2019-09-12 11:44:49
date last changed
2019-09-26 04:42:03
@article{16908ef0-a9b1-4912-b79a-f18942bc1ce4,
  abstract     = {<p>Background and purpose: Our purpose was to study the association between country of birth and incident epilepsy in second-generation immigrants in Sweden. Methods: The study population included all children (n = 4 023 149) aged up to 18 years in Sweden. Epilepsy was defined as at least one registered diagnosis of epilepsy in the National Patient Register. The incidence of epilepsy, using individuals with Swedish-born parents as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence interval (95% CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and comorbid conditions, also using data from the Total Population Register. Results: A total of 26 310 individuals had a registered epilepsy event, i.e. 6.5/1000 (6.6/1000 amongst boys and 6.3/1000 amongst girls). After adjustment, the risk of epilepsy was lower than in children of Swedish-born parents. Amongst girls the significant HR was 0.85 (95% CI 0.81–0.88), but in boys only when adjusting also for comorbidity (HR 0.96, 95% CI 0.92–0.99). Amongst specific immigrant groups, a higher incidence of epilepsy was observed amongst boys with parents from Turkey and Africa, but not when adjusting for comorbidity, and a lower risk was observed in many other groups (boys with parents from Latvia, girls with parents from Finland, Iceland, Southern Europe, countries from the former Yugoslavia, and Asia). Conclusion: The risk of epilepsy was lower in second-generation immigrant children compared to children with Swedish-born parents, but with substantial differences between different immigrant groups.</p>},
  author       = {Wändell, P. and Fredrikson, S. and Carlsson, A. C. and Li, X. and Gasevic, D. and Sundquist, J. and Sundquist, K.},
  issn         = {1351-5101},
  keyword      = {epilepsy,gender,incidence,second-generation immigrants,socioeconomic status},
  language     = {eng},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Neurology},
  title        = {Epilepsy in second-generation immigrants : a cohort study of all children up to 18 years of age in Sweden},
  url          = {http://dx.doi.org/10.1111/ene.14049},
  year         = {2019},
}