Highlights
- •Parents of children with MS completed a detailed questionnaire of early life exposures.
- •Early flu-like illness and playing on grass were associated with increased risk of MS.
- •This difference did not reach statistical significance in multivariable models.
- •Early infectious exposures do not appear to significantly alter risk of pediatric MS.
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
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Article info
Publication history
Published online: March 26, 2018
Accepted:
March 20,
2018
Received in revised form:
February 16,
2018
Received:
November 19,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
