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

Research output: Contribution to journalArticle


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.


External organisations
  • Karolinska Institutet
  • University of Edinburgh
  • Monash University
  • Icahn School of Medicine at Mount Sinai
  • Shimane University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics


  • epilepsy, gender, incidence, second-generation immigrants, socioeconomic status
Original languageEnglish
JournalEuropean Journal of Neurology
Publication statusE-pub ahead of print - 2019
Publication categoryResearch