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.
Alazem et al. (Sun,) studied this question.