Jennifer S Graves1, Tanuja Chitnis2, Bianca Weinstock-Guttman3, Jennifer Rubin4, Aaron S Zelikovitch4, Bardia Nourbakhsh5, Timothy Simmons6, Michael Waltz6, T Charles Casper6, Emmanuelle Waubant5. 1. Pediatric Multiple Sclerosis Center, University of California San Francisco, San Francisco, California; jennifer.graves@ucsf.edu. 2. Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, Massachusetts. 3. Jacobs Neurological Institute, University of Buffalo, Buffalo, New York. 4. Lurie Children's Hospital of Chicago, Chicago, Illinois; and. 5. Pediatric Multiple Sclerosis Center, University of California San Francisco, San Francisco, California. 6. Data Coordinating and Analysis Center, University of Utah, Salt Lake City, Utah.
Abstract
OBJECTIVE: To determine if prenatal, pregnancy, or postpartum-related environmental factors are associated with multiple sclerosis (MS) risk in children. METHODS: This is a case-control study of children with MS or clinically isolated syndrome and healthy controls enrolled at 16 clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire, including the capture of pregnancy and perinatal factors. Case status was confirmed by a panel of 3 pediatric MS specialists. Multivariable logistic regression analyses were used to determine association of these environmental factors with case status, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status. RESULTS: Questionnaire responses were available for 265 eligible cases (median age 15.7 years, 62% girls) and 412 healthy controls (median age 14.6, 54% girls). In the primary multivariable analysis, maternal illness during pregnancy was associated with 2.3-fold increase in odds to have MS (95% confidence interval [CI] 1.20-4.21, P = .01) and cesarean delivery with 60% reduction (95% CI 0.20-0.82, P = .01). In a model adjusted for these variables, maternal age and BMI, tobacco smoke exposure, and breastfeeding were not associated with odds to have MS. In the secondary analyses, after adjustment for age, sex, race, ethnicity, and socioeconomic status, having a father who worked in a gardening-related occupation (odds ratio [OR] 2.18, 95% CI 1.14-4.16, P = .02) or any use in household of pesticide-related products (OR 1.73, 95% CI 1.06-2.81, P = .03) were both associated with increased odds to have pediatric MS. CONCLUSION: Cesarean delivery and maternal health during pregnancy may influence risk for pediatric-onset MS. We report a new possible association of pesticide-related environmental exposures with pediatric MS that warrants further investigation and replication.
OBJECTIVE: To determine if prenatal, pregnancy, or postpartum-related environmental factors are associated with multiple sclerosis (MS) risk in children. METHODS: This is a case-control study of children with MS or clinically isolated syndrome and healthy controls enrolled at 16 clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire, including the capture of pregnancy and perinatal factors. Case status was confirmed by a panel of 3 pediatric MS specialists. Multivariable logistic regression analyses were used to determine association of these environmental factors with case status, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status. RESULTS: Questionnaire responses were available for 265 eligible cases (median age 15.7 years, 62% girls) and 412 healthy controls (median age 14.6, 54% girls). In the primary multivariable analysis, maternal illness during pregnancy was associated with 2.3-fold increase in odds to have MS (95% confidence interval [CI] 1.20-4.21, P = .01) and cesarean delivery with 60% reduction (95% CI 0.20-0.82, P = .01). In a model adjusted for these variables, maternal age and BMI, tobacco smoke exposure, and breastfeeding were not associated with odds to have MS. In the secondary analyses, after adjustment for age, sex, race, ethnicity, and socioeconomic status, having a father who worked in a gardening-related occupation (odds ratio [OR] 2.18, 95% CI 1.14-4.16, P = .02) or any use in household of pesticide-related products (OR 1.73, 95% CI 1.06-2.81, P = .03) were both associated with increased odds to have pediatric MS. CONCLUSION: Cesarean delivery and maternal health during pregnancy may influence risk for pediatric-onset MS. We report a new possible association of pesticide-related environmental exposures with pediatric MS that warrants further investigation and replication.
Authors: C R Cardwell; L C Stene; G Joner; O Cinek; J Svensson; M J Goldacre; R C Parslow; P Pozzilli; G Brigis; D Stoyanov; B Urbonaite; S Sipetić; E Schober; C Ionescu-Tirgoviste; G Devoti; C E de Beaufort; K Buschard; C C Patterson Journal: Diabetologia Date: 2008-02-22 Impact factor: 10.122
Authors: Lars C Stene; Katherine Barriga; Jill M Norris; Michelle Hoffman; Henry A Erlich; George S Eisenbarth; Robert S McDuffie; Marian Rewers Journal: Am J Epidemiol Date: 2004-07-01 Impact factor: 4.897
Authors: Leena Suleiman; Emmanuelle Waubant; Gregory Aaen; Anita Belman; Leslie Benson; Meghan Candee; Tanuja Chitnis; Mark Gorman; Manu Goyal; Benjamin Greenberg; Yolanda Harris; Janace Hart; Ilana Kahn; Lauren Krupp; Timothy Lotze; Soe Mar; Manikum Moodley; Jayne Ness; Bardia Nourbakhsh; Mary Rensel; Moses Rodriguez; John Rose; Jennifer Rubin; Teri Schreiner; Jan-Mendelt Tillema; Amy Waldman; Bianca Weinstock-Guttman; T Charles Casper; Michael Waltz; Jennifer S Graves Journal: Mult Scler Relat Disord Date: 2018-03-26 Impact factor: 4.339
Authors: Enrique González-Madrid; Ma Andreina Rangel-Ramírez; María José Mendoza-León; Oscar Álvarez-Mardones; Pablo A González; Alexis M Kalergis; Ma Cecilia Opazo; Claudia A Riedel Journal: Int J Mol Sci Date: 2022-06-25 Impact factor: 6.208
Authors: Anna Knyszyńska; Karolina Skonieczna-Żydecka; Dorota Koziarska; Laura Stachowska; Artur Kotwas; Monika Kulaszyńska; Anna Lubkowska; Beata Karakiewicz Journal: Int J Environ Res Public Health Date: 2022-05-27 Impact factor: 4.614
Authors: Darren J Fernandes; Shoshana Spring; Mark R Palmert; Jason P Lerch; Christina Corre; Andrew Tu; Lily R Qiu; Christopher Hammill; Dulcie A Vousden; T Leigh Spencer Noakes; Brian J Nieman; Dawn M E Bowdish; Jane A Foster Journal: Mol Psychiatry Date: 2022-04-14 Impact factor: 13.437
Authors: Soe Mar; Shannon Liang; Michael Waltz; T Charles Casper; Manu Goyal; Benjamin Greenberg; Bianca Weinstock-Guttman; Moses Rodriguez; Gregory Aaen; Anita Belman; Lisa F Barcellos; John Rose; Mark Gorman; Leslie Benson; Meghan Candee; Tanjua Chitnis; Yolanda Harris; Ilana Kahn; Shelly Roalsted; Janace Hart; Timothy Lotze; Manikum Moodley; Jayne Ness; Mary Rensel; Jennifer Rubin; Teri Schreiner; Jan-Mendelt Tillema; Amy Waldman; Lauren Krupp; Jennifer S Graves; Emmanuelle Waubant Journal: Ann Clin Transl Neurol Date: 2018-10-09 Impact factor: 4.511
Authors: Emmanuelle Waubant; Robyn Lucas; Ellen Mowry; Jennifer Graves; Tomas Olsson; Lars Alfredsson; Annette Langer-Gould Journal: Ann Clin Transl Neurol Date: 2019-08-07 Impact factor: 4.511