Maternal and Perinatal Exposures Are Associated With Risk for Pediatric-Onset Multiple Sclerosis

Abstract

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.

Several household chemical exposures are associated with pediatric‐onset multiple sclerosis

“…Investigating occupational exposures may also elucidate environmental associations and risk for MS. We previously reported increased risk of pediatric‐onset MS in participants whose fathers had worked in agricultural occupations during the perinatal period 11. While data are limited, an Australian case‐control study of adults showed that some occupational exposures were strongly associated with increased risk of a first CNS demyelinating event, itself often followed by MS 14.…”

“…These results are consistent with our prior observations linking pediatric MS onset to certain environmental exposures just prior to pregnancy and through the first year of life. 11 An ecological study investigating the potential link between environmental pesticide exposures and various neurologic and psychiatric conditions in southern Spain, reported an increased prevalence of adult MS in areas of high, compared to low, agricultural pesticide exposure (OR 1.23, 95% CI 1.05-1.43). 12 Other environmental exposures, such as heavy metals and solvents, exhibited a stronger association with MS. 12 Pesticides and other environmental toxic agents have been associated with neurodegeneration possibly due to effects of reactive oxygen species in nerve tissue, based on animal studies.…”

“…Investigating occupational exposures may also elucidate environmental associations and risk for MS. We previously reported increased risk of pediatric-onset MS in participants whose fathers had worked in agricultural occupations during the perinatal period. 11 While data are limited, an Australian case-control study of adults showed that some occupational exposures were strongly associated with increased risk of a first CNS demyelinating event, itself often followed by MS. 14 For women, there was an increased risk for a first CNS demyelinating event with ≥10 years of exposure to livestock (adjusted odds ratio [AOR] 2.78, 95% CI 1.22-6.33), as well as farming for ≥6 years (AOR 2.00, 95% CI 1.23-3.25). These findings were not seen among men.…”

“…As we have previously reported associations related to before and during pregnancy, we have excluded exposures occurring 3 months before or during the pregnancy. 11 For cases, only toxic exposures that took place before disease onset were included. Otherwise, the case was considered unexposed.…”

“…We have previously reported that pesticide exposures in the household in the perinatal period were associated with increased risk of pediatric‐onset MS 11. Our goal was to identify associations between exposures to household chemicals during childhood and the risk of pediatric‐onset MS, and annualized relapse rate in those with the disease.…”