Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis

on behalf of the Network of Pediatric Multiple Sclerosis Centers.

Research output: Contribution to journalArticle

Abstract

Objective: We sought to determine if early infectious exposures such as daycare, early use of antibiotics, vaccinations and other germ exposures including pacifier use and playing on grass are associated with multiple sclerosis (MS) risk in children. Methods: This was a case-control study of children with MS or clinically isolated syndrome (CIS) and healthy controls enrolled at sixteen clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire that captured early infectious exposures, habits, and illnesses in the first five years of life. A panel of at least two pediatric MS specialists confirmed diagnosis of participants. Association of early infectious variables with diagnosis was assessed via multivariable logistic regression analyses, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status (SES). Results: Questionnaire responses for 326 eligible cases (mean age 14.9, 63.5% girls) and 506 healthy pediatric subjects (mean age 14.4, 56.9% girls) were included in analyses. History of flu with high fever before age five (p = 0.01), playing outside in grass and use of special products to treat head lice or scabies (p = 0.04) were associated with increased risk of MS in unadjusted analyses. In the multivariable model adjusted for age, sex, race, ethnicity, and mother's highest educational attainment, these results were not statistically significant. Notably, antibiotic use (p = 0.22) and regular daycare attendance before age 6 (p = 0.09) were not associated with odds of developing MS. Conclusion: Early infectious factors investigated in this study were not associated with MS risk.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalMultiple Sclerosis and Related Disorders
Volume22
DOIs
StatePublished - May 1 2018

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Multiple Sclerosis
Pediatrics
Poaceae
Pacifiers
Pediculus
Anti-Bacterial Agents
Scabies
Social Class
Habits
Case-Control Studies
Healthy Volunteers
Vaccination
Fever
Parents
Logistic Models
Regression Analysis
Mothers
Parturition

Keywords

  • Childhood infection
  • Epidemiology
  • Multiple sclerosis
  • Neonatal exposure

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis. / on behalf of the Network of Pediatric Multiple Sclerosis Centers.

In: Multiple Sclerosis and Related Disorders, Vol. 22, 01.05.2018, p. 103-107.

Research output: Contribution to journalArticle

on behalf of the Network of Pediatric Multiple Sclerosis Centers. / Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis. In: Multiple Sclerosis and Related Disorders. 2018 ; Vol. 22. pp. 103-107.
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title = "Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis",
abstract = "Objective: We sought to determine if early infectious exposures such as daycare, early use of antibiotics, vaccinations and other germ exposures including pacifier use and playing on grass are associated with multiple sclerosis (MS) risk in children. Methods: This was a case-control study of children with MS or clinically isolated syndrome (CIS) and healthy controls enrolled at sixteen clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire that captured early infectious exposures, habits, and illnesses in the first five years of life. A panel of at least two pediatric MS specialists confirmed diagnosis of participants. Association of early infectious variables with diagnosis was assessed via multivariable logistic regression analyses, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status (SES). Results: Questionnaire responses for 326 eligible cases (mean age 14.9, 63.5{\%} girls) and 506 healthy pediatric subjects (mean age 14.4, 56.9{\%} girls) were included in analyses. History of flu with high fever before age five (p = 0.01), playing outside in grass and use of special products to treat head lice or scabies (p = 0.04) were associated with increased risk of MS in unadjusted analyses. In the multivariable model adjusted for age, sex, race, ethnicity, and mother's highest educational attainment, these results were not statistically significant. Notably, antibiotic use (p = 0.22) and regular daycare attendance before age 6 (p = 0.09) were not associated with odds of developing MS. Conclusion: Early infectious factors investigated in this study were not associated with MS risk.",
keywords = "Childhood infection, Epidemiology, Multiple sclerosis, Neonatal exposure",
author = "{on behalf of the Network of Pediatric Multiple Sclerosis Centers.} and Leena Suleiman and Emmanuelle Waubant and Gregory Aaen and Anita Belman and Leslie Benson and Meghan Candee and Tanuja Chitnis and Mark Gorman and Manu Goyal and Benjamin Greenberg and Yolanda Harris and Janace Hart and Ilana Kahn and Lauren Krupp and Timothy Lotze and Soe Mar and Manikum Moodley and Jayne Ness and Bardia Nourbakhsh and Mary Rensel and Moses Rodriguez and John Rose and Jennifer Rubin and Teri Schreiner and Tillema, {Jan Mendelt} and Amy Waldman and Bianca Weinstock-Guttman and Casper, {T. Charles} and Michael Waltz and Graves, {Jennifer S.}",
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T1 - Early infectious exposures are not associated with increased risk of pediatric-onset multiple sclerosis

AU - on behalf of the Network of Pediatric Multiple Sclerosis Centers.

AU - Suleiman, Leena

AU - Waubant, Emmanuelle

AU - Aaen, Gregory

AU - Belman, Anita

AU - Benson, Leslie

AU - Candee, Meghan

AU - Chitnis, Tanuja

AU - Gorman, Mark

AU - Goyal, Manu

AU - Greenberg, Benjamin

AU - Harris, Yolanda

AU - Hart, Janace

AU - Kahn, Ilana

AU - Krupp, Lauren

AU - Lotze, Timothy

AU - Mar, Soe

AU - Moodley, Manikum

AU - Ness, Jayne

AU - Nourbakhsh, Bardia

AU - Rensel, Mary

AU - Rodriguez, Moses

AU - Rose, John

AU - Rubin, Jennifer

AU - Schreiner, Teri

AU - Tillema, Jan Mendelt

AU - Waldman, Amy

AU - Weinstock-Guttman, Bianca

AU - Casper, T. Charles

AU - Waltz, Michael

AU - Graves, Jennifer S.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Objective: We sought to determine if early infectious exposures such as daycare, early use of antibiotics, vaccinations and other germ exposures including pacifier use and playing on grass are associated with multiple sclerosis (MS) risk in children. Methods: This was a case-control study of children with MS or clinically isolated syndrome (CIS) and healthy controls enrolled at sixteen clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire that captured early infectious exposures, habits, and illnesses in the first five years of life. A panel of at least two pediatric MS specialists confirmed diagnosis of participants. Association of early infectious variables with diagnosis was assessed via multivariable logistic regression analyses, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status (SES). Results: Questionnaire responses for 326 eligible cases (mean age 14.9, 63.5% girls) and 506 healthy pediatric subjects (mean age 14.4, 56.9% girls) were included in analyses. History of flu with high fever before age five (p = 0.01), playing outside in grass and use of special products to treat head lice or scabies (p = 0.04) were associated with increased risk of MS in unadjusted analyses. In the multivariable model adjusted for age, sex, race, ethnicity, and mother's highest educational attainment, these results were not statistically significant. Notably, antibiotic use (p = 0.22) and regular daycare attendance before age 6 (p = 0.09) were not associated with odds of developing MS. Conclusion: Early infectious factors investigated in this study were not associated with MS risk.

AB - Objective: We sought to determine if early infectious exposures such as daycare, early use of antibiotics, vaccinations and other germ exposures including pacifier use and playing on grass are associated with multiple sclerosis (MS) risk in children. Methods: This was a case-control study of children with MS or clinically isolated syndrome (CIS) and healthy controls enrolled at sixteen clinics participating in the US Network of Pediatric MS Centers. Parents completed a comprehensive environmental questionnaire that captured early infectious exposures, habits, and illnesses in the first five years of life. A panel of at least two pediatric MS specialists confirmed diagnosis of participants. Association of early infectious variables with diagnosis was assessed via multivariable logistic regression analyses, adjusting for age, sex, race, ethnicity, US birth region, and socioeconomic status (SES). Results: Questionnaire responses for 326 eligible cases (mean age 14.9, 63.5% girls) and 506 healthy pediatric subjects (mean age 14.4, 56.9% girls) were included in analyses. History of flu with high fever before age five (p = 0.01), playing outside in grass and use of special products to treat head lice or scabies (p = 0.04) were associated with increased risk of MS in unadjusted analyses. In the multivariable model adjusted for age, sex, race, ethnicity, and mother's highest educational attainment, these results were not statistically significant. Notably, antibiotic use (p = 0.22) and regular daycare attendance before age 6 (p = 0.09) were not associated with odds of developing MS. Conclusion: Early infectious factors investigated in this study were not associated with MS risk.

KW - Childhood infection

KW - Epidemiology

KW - Multiple sclerosis

KW - Neonatal exposure

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