RESUMEN
BACKGROUND: Compared with children born of Danish mothers, the mortality of children, born and living in Denmark, is significantly increased in those with a mother from Afghanistan, Iraq, Pakistan, Somalia, and Turkey. Consanguinity has been suggested to account for part of this disparity. Since information on consanguinity is lacking, this suggestion is difficult to test. With an indirect approach, we addressed this question by comparing the risk of diseases with autosomal recessive inheritance in children born in Denmark of Danish-born women and of women born in these five countries, respectively. METHODS: All children born in Denmark (1994-2010) were followed until 5 years of age or end-of-study period for the risk of hospitalisation with diseases of autosomal recessive aetiology, and therefore considered consanguinity-related. Diagnoses of autosomal recessive diseases were identified using two different methods: a literature review of consanguinity-associated diseases and a search in the Online Catalogue of Human Genes and Genetic Disorders. Risks were also calculated for diseases with known non-autosomal recessive aetiology (considered non-consanguinity-related). We estimated adjusted hazard ratios for the diseases in children of foreign-born women compared with children of Danish-born women. RESULTS: Compared with offspring of Danish-born women, the risk of a consanguinity-related disease was significantly increased in children of foreign-born women, although the absolute risk was low. The risk of non-consanguinity-related diseases did not differ between the groups compared. CONCLUSIONS: The findings support the hypothesis that consanguinity accounts for some, however a minor part, of the disparity in child mortality among migrants in Denmark.
Asunto(s)
Mortalidad del Niño/etnología , Consanguinidad , Enfermedades Genéticas Congénitas/mortalidad , Madres , Migrantes , Adulto , Afganistán/etnología , Preescolar , Análisis Mutacional de ADN , Dinamarca/etnología , Femenino , Genes Recesivos , Enfermedades Genéticas Congénitas/genética , Humanos , Incidencia , Lactante , Recién Nacido , Irak/etnología , Masculino , Mutación Missense , Pakistán/etnología , Linaje , Sistema de Registros , Somalia/etnología , Turquía/etnologíaRESUMEN
To examine whether an excess risk of maternal mortality exists among migrant women in Western Europe. We searched electronic databases for studies published 1970 through 2013 for all observational studies comparing maternal mortality between the host country and a defined migrant population. Results were derived from a random-effects meta-analysis, and statistical heterogeneity assessed by the I (2) statistic. In sub-analyses we also calculated summary estimates stratified by direct and indirect death causes. We included 13 studies with more than 42 million women and 4,995 maternal deaths. Compared with indigenous born women, the pooled risk estimate (RR) was 2.00 with 95 % confidence interval (CI) of 1.72, 2.33. Migrant women had a non-significantly higher risk of dying from direct than indirect death causes; pooled RRs of 2.65 CI 1.88, 3.74 and 1.83 CI 1.37, 2.45. This meta-analysis provides evidence that migrant women in Western European countries have an excess risk of maternal mortality.
Asunto(s)
Mortalidad Materna , Migrantes/estadística & datos numéricos , Europa (Continente)/epidemiología , Femenino , Humanos , Mortalidad Materna/etnología , Atención Prenatal/normas , Medición de RiesgoRESUMEN
Objective : To examine differences in oral cleft (OC) occurrence based on maternal only and parental country of origin in Denmark from 1981 to 2002. Methods : Data on all live births from the Danish Medical Birth Register from 1981 to 2002 were linked with the Danish Facial Cleft Database. Cleft cases were categorized into isolated and nonisolated cleft lip with or without palate (CL/P) and cleft palate only (CP). Birth prevalence was calculated as cases per 1,000 live born children by maternal country of origin, world region, and mixed parental groups. Results : We identified 3094 OC cases among 1,319,426 live births. Danish-born women had an OC birth prevalence of 2.38 with a 95% confidence interval (CI) (2.29-2.47) and foreign-born women a significant lower prevalence of 2.01 (CI, 1.77-2.27). This difference was explained by a lower isolated CL/P birth prevalence among foreign-born women of 0.97 (CI, 0.81-1.16) versus 1.35 (CI, 1.28-1.41). No significant differences were seen for the remaining subtypes. Parents with the same foreign country of origin had a lower overall OC (1.63; CI, 1.35-1.94) and isolated CL/P (0.76; CI, 0.57-0.99) birth prevalence than Danish-born parents. This was not the case for any of the mixed parental groups. Overall and subtype prevalence rates varied according to maternal categories of world region. Conclusion : In this study we found differences in OC occurrence among all live births in the Danish population based on maternal country of origin from 1981 to 2002. Danish-born women had higher OC and isolated CL/P birth prevalence compared with foreign-born women.
Asunto(s)
Labio Leporino/etnología , Fisura del Paladar/etnología , Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Dinamarca/epidemiología , Femenino , Humanos , Recién Nacido , Masculino , Prevalencia , Sistema de RegistrosRESUMEN
The objective of the study was to describe ethnic differences in under-five-years mortality in Denmark according to maternal country of origin. We conducted a large registry-linkage study of all singleton live-born children from mothers born in Denmark and from the ten largest migrant groups (n = 1,841,450). Study outcomes were death before the age of 5 years from all causes combined and the most frequent death causes. Results showed that children of mothers of Turkish, Pakistani, Somali and Iraqi origin had an elevated risk of dying before the age of five compared to offspring of mothers born in Denmark, with hazards ratios and 95% confidence intervals of 1.48 (1.31-1.67), 1.97 (1.68-2.32), 1.70 (1.29-2.25), and 1.92 (1.41-2.62), respectively. Ethnic differences were also observed in the underlying causes of death. Children of mothers born in Former Yugoslavia, Lebanon, Norway, Sweden, Iran, and Afghanistan did not differ in under-five-years mortality from ethnic Danish children. Adjustments for household income did not attenuate the risk estimates. In conclusion, we found excess child mortality in some migrant groups, but not in all. The differences could not be explained by socioeconomic status.
Asunto(s)
Mortalidad del Niño/etnología , Preescolar , Dinamarca/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Factores SocioeconómicosRESUMEN
Independent associations between personal- and demographic characteristics and physical activity in 3-6 year old children attending preschool were identified in this study. Boys spent a larger proportion of the time on moderate-and-vigorous physical activity (MVPA; p < .001) and had a higher total physical activity level compared with girls (p < .001). The 3-4 year old children spent less time on MVPA and had a lower total physical activity level compared with both 4-5 (p < .01) and 5-6 year old children (p < .001). The individual preschool, gender and age of preschool children were strong predictors of physical activity (R2-total model=(0.36-0.39)) during preschool attendance.