BACKGROUND: Spring birth has been found to be associated with increase in the risk of MS. However, this effect is reportedly found particularly in HLA-DR15 positive patients. OBJECTIVE: Examine the month of birth (MOB) effect in Finnish MS patients and its association with HLA-DR15. METHODS: Using the national register on hospitalizations during 1979-2004 we identified 8359 MS patients. We used a χ(2)-analysis to compare the distribution of MOB in MS patients versus age-adjusted controls. Patients were subdivided into 10-year birth cohorts to analyse temporal variations in MOB. A subgroup of HLA-typed MS patients (n = 657) and a population sample of healthy donors from the Finnish Bone Marrow Donor Registry (n = 19,805) were included to analyse connections between HLA-DR15 and MOB. RESULTS: An April birth was associated with a 9.4% increased risk of MS (p = 0.008), whereas November birth was associated with an 11.1% decreased risk (p = 0.004) compared with the expected birth distribution. No temporal clustering in the MOB effect was found during 1900-1988. Both HLA-DR15 positive (34% increase, p = 0.043) and DR15 negative (48% increase, p = 0.0095) MS patients exhibited an increase in spring births (in May). HLA-DR15 in healthy subjects was not associated with MOB. CONCLUSIONS: We confirm that spring birth increases MS risk. This phenomenon was not associated with HLA-DR15 and there was no evidence of temporal clustering. The MOB effect suggests that early developmental processes may modulate MS risk.
BACKGROUND: Spring birth has been found to be associated with increase in the risk of MS. However, this effect is reportedly found particularly in HLA-DR15 positive patients. OBJECTIVE: Examine the month of birth (MOB) effect in Finnish MS patients and its association with HLA-DR15. METHODS: Using the national register on hospitalizations during 1979-2004 we identified 8359 MS patients. We used a χ(2)-analysis to compare the distribution of MOB in MS patients versus age-adjusted controls. Patients were subdivided into 10-year birth cohorts to analyse temporal variations in MOB. A subgroup of HLA-typed MS patients (n = 657) and a population sample of healthy donors from the Finnish Bone Marrow Donor Registry (n = 19,805) were included to analyse connections between HLA-DR15 and MOB. RESULTS: An April birth was associated with a 9.4% increased risk of MS (p = 0.008), whereas November birth was associated with an 11.1% decreased risk (p = 0.004) compared with the expected birth distribution. No temporal clustering in the MOB effect was found during 1900-1988. Both HLA-DR15 positive (34% increase, p = 0.043) and DR15 negative (48% increase, p = 0.0095) MS patients exhibited an increase in spring births (in May). HLA-DR15 in healthy subjects was not associated with MOB. CONCLUSIONS: We confirm that spring birth increases MS risk. This phenomenon was not associated with HLA-DR15 and there was no evidence of temporal clustering. The MOB effect suggests that early developmental processes may modulate MS risk.
Authors: Giulio Disanto; George Chaplin; Julia M Morahan; Gavin Giovannoni; Elina Hyppönen; George C Ebers; Sreeram V Ramagopalan Journal: BMC Med Date: 2012-07-06 Impact factor: 8.775