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1.
Objective –  To estimate the risk of multiple sclerosis (MS) by month of birth in Sweden.
Materials and Methods –  Cases ( n  = 9361) were obtained from the Swedish MS Registry. All births in Sweden 1900–2007 served as controls ( n  = 12,116,853). The risk of MS was analyzed for each month of birth separately compared with birth during the other 11 months.
Results –  More (11%) cases with MS than expected were born in June. Fewer (8% and 10%) cases with MS than expected were born in December and January (non-significant after correction for multiple analyses). More (5%) cases with MS than expected were born in February–July as compared with August–January.
Conclusions –  This study supports previous results suggesting an association between the risk of MS and the season of birth. Decreased exposure to sun in the winter leading to low vitamin D levels during pregnancy is a possible explanation that needs further research.  相似文献   

2.
Objectives – Epidemiological studies strongly indicate an infectious involvement in multiple sclerosis (MS). Epstein–Barr virus (EBV), to which all multiple sclerosis patients are seropositive, is also interesting from an epidemiological point of view. We have reported a cluster of MS patients with 8 members from a small Danish community called Fjelsø. To further evaluate the role of EBV in MS we have investigated the distribution of EBV subtypes in cluster members and in control cohorts. Materials and methods – Blood mononuclear cells were isolated from cluster members, unrelated MS patients, healthy controls, including healthy schoolmates to the Fjelstø cluster patients and finally from persons with autoimmune diseases in order to investigate the number of 39 bp repeats in the EBNA 6-coding region in the EBV seropositive individuals. Results – We observed a preponderance of the subtype with 3 39 bp repeats in the EBNA 6-coding region both in the MS patients and the healthy controls. In the Fjelsø cluster all 8 cluster members were harbouring this subtype, which is significantly different from the finding in healthy controls ( n = 16), which include 8 schoolmates to the cluster members and 8 randomly selected healthy persons (Fischer's exact test P =0.0047), and also compared to all non-clustered individuals studied ( P =0.017). Conclusion – Infection with the same subtype of EBV links together the 8 persons from the Fjelso cluster who later developed MS. This finding adds to the possibility that development of MS is linked to infection with EBV.  相似文献   

3.
Objective –  The objective of this study was to investigate the effect of maternal multiple sclerosis (MS) on delivery and birth outcome in births without planned caesarean section.
Methods –  Data were collected from the compulsory Medical Birth Registry of Norway from 1988 to 2002. Intended vaginal births in this time period were 449 births given by MS mothers and 851,060 control births.
Results –  The MS mothers had a higher rate of induction of labour, and there was a strong trend for slower progression of second stage of labour and increased use of forceps. The MS group had lower birth weight and length of the neonates. The frequency of birth defects and the neonatal mortality were not increased in the MS group.
Conclusions –  Maternal MS affects the birth process and the neonate prenatally, even when the births with planned caesarean section are excluded. MS-related neuronal dysfunction linked to the uterus, is postulated as the most likely mechanism.  相似文献   

4.
Introduction . – Few studies have examined the factors of occupational environment related to unemployment in multiple sclerosis (MS). Material and methods . – A case control-study was carried out. Cases were patients unemployed for less than five years before the study (n = 77); controls were patients currently employed (n = 94). The odds ratios of the relationship under study adjusted for sex, age, disease form and educational level, were estimated. Results . – Employment in the public sector, sedentary jobs and possibility of obtaining specific improvements in the work environment were found to be protective factors, while jobs needing force, rigid work schedule, manual precision, frequent moves and a daily work duration over 8 h were found as risk factors. Multivariate analyses showed that the only remaining factors were public sector jobs as protective factor (OR = 0.4), and strenuous work as risk factor (OR = 4.5). Factors were slightly different in male and female patients. Conclusion . – This study suggests that simple and early changes in the occupational environment could maintain MS patients at work.  相似文献   

5.
Risk of multiple sclerosis inversely associated with birth order position   总被引:3,自引:0,他引:3  
The aim of this study was to ascertain whether there is an association between risk of multiple sclerosis (MS) and birth order position. Our reference population was 198,000 persons born in the period 1930–50 and recorded in the register of school health records from the school health service of the Copenhagen council. We compared 46 persons from the register who had developed MS with matched controls from the register, three for each case. An inverse association between risk of MS and birth order position was found. Early birth orders tend to delay exposure to an infectious agent from early childhood to a later age. Therefore, our finding supports the hypothesis that MS is causally related to an infection that is inapparent when it occurs in early childhood, while infection later in life may result in severe disease.  相似文献   

6.
Introduction – Disease associations may provide useful etiological leads in relation to diseases of unknown cause. Material and methods – We conducted a hospital-based case-control study of 155 MS patients and 200 controls in Hordaland County, Norway to investigate the possible association between MS and autoimmune diseases. Results – The MS patients had a statistically significant more frequent coexistence of rheumatoid arthritis, psoriasis, and goitre when compared to the controls (OR = 2.96; 95% CI 1.23–7.66). This difference persisted when analysing the definite MS cases separately (OR = 2.90; 95% CI 1.10–7.96). The familial occurrence of chronic inflammatory diseases was not significantly different in cases and controls. A significant increased risk to develop MS occurred in first degree relatives of MS patients (OR = 12.58; 95% CI 1.73–552). Conclusion – Acknowledging the low figures, the uncertain estimates with large confidence intervals, and thus the obvious role of chance in this study, the results might indicate that a generalized, genetically controlled problem of the immune system could result in aggregates of the reported diseases, all of which are partly characterized by abberrations of the immune system.  相似文献   

7.
In the present study, we found no association between multiple sclerosis (MS; definite and probable, n = 211) and birth order (p = 0.1411). The observed number of first-born patients did not differ significantly from the expected number (p = 0.0871). While there was a significantly high birth order (n = 258, p = 0.0381) and a marginally significant low number of first-borns (p = 0.0475) when possible MS cases were included, an artefact due to the population structure may have accentuated this result. In comparison with the control birth cohort, there was no significant association with birth order (p = 0.0742) or the proportion of first-borns (p = 0.220) in a subgroup from the MS incidence cohort born between 1915 and 1929 (n = 158). Birth order had no major impact on the risk of subsequent MS in this study.  相似文献   

8.
Disability and mortality in multiple sclerosis in Western Norway   总被引:1,自引:0,他引:1  
Introduction – Continued studies of frequency trends in carefully selected sites around the world can provide clues to the cause of multiple sclerosis (MS). Material and methods – Based on information from three different, semi-independant sources of information, we have examined the temporal trends in the average annual age-adjusted rates of disability pension incidence, mortality, and incidence of MS from 1966 to 1991 in More and Romsdal County, Norway. Results – The average annual age-adjusted disability pension incidence rates (1966–68 = 3.62/100,000; 1990–91 = 7.33/100,000), the mortality rates (1966–68=0.91/100,000; 1990–91 = 1.88/100,000), and the incidence rates (1966–68 = 4.22/100,000; 1990–91 = 5.02/100,000) all showed a statistically significant increase. The difference in the development of MS-specific disability pension prevalence rates in the county compared to the nation is notable. Conclusions – We consider that the increase in disability pension incidence, mortality, and incidence of MS is of biological significance. Thus three different sources of information corroborate corresponding trends indicating that better case ascertainment and improved diagnostic facilities only partially can explain the reported MS increase in western Norway.  相似文献   

9.
To investigate the influence of maternal multiple sclerosis (MS) on pregnancy, we compared pregnancy, delivery and birth outcome in births prior to onset of MS (pre MS), between MS onset and diagnosis (early MS), and after diagnosis of MS (manifest MS). Mothers with MS were identified through linkage of the Norwegian MS Registry and the Medical Birth Registry of Norway (1967-2002). All pre MS births (n = 1910), early MS births (n = 555), and manifest MS births (n = 308) were compared.There was a significantly lower mean birth weight in term births (adjusted for gestation in weeks, mother's age, time period and caesarean section) in the manifest MS compared to the pre MS group (P = 0.046). The rate of birth complications and interventions did not differ between the three groups.Manifest MS in birth-giving mothers seems to affect birth weight.  相似文献   

10.
Objectives –  Multiple sclerosis (MS) likely results from an interaction between genetic and exogenous factors. While genetics shapes the overall population MS susceptibility, observed epidemiological patterns strongly suggest a role for the environment in disease initiation and modulation.
Results –  Findings from studies on seasonality in MS patients' birth, disease onset and exacerbations, as well as apparent temporal trends in incidence and gender ratio support an influential effect of viruses, metabolic and lifestyle factors on MS risk. Epstein–Barr virus, vitamin D status, and smoking are factors that may explain such epidemiological patterns.
Conclusions –  Further epidemiological investigations are encouraged and opportunities to use data from existing cohort studies as well as the design of new studies should be pursued. In particular, the development of new large multicentre population-based case-control studies which incorporate the study of the role of environment and genetics, including epigenetic mechanisms, in determining MS risk is proposed.  相似文献   

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