Cesarean section and offspring’s risk of multiple sclerosis: a Danish nationwide cohort study

Abstract

Background:

Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS.

Objectives:

We studied the association between C-section and risk of MS, in a cohort of 1.7 million Danes born from 1973 to 2005.

Methods:

Information on C-section and MS was obtained from the Danish Medical Birth Register and the Danish MS Register, respectively. The association between C-section and MS was evaluated by means of MS incidence rate ratios (RR) with 95% confidence intervals (CI) obtained in log-linear Poisson regression analyses.

Results:

There were 930 cases of MS in the study cohort, of whom 80 (9%) were delivered by C-section. Overall, we found there was no significant association between C-section and risk of MS (RR = 1.17; 0.92–1.46). Analyses stratified by sex revealed no unusual risk of MS for women (RR = 1.08: 0.80–1.42) nor men (RR = 1.37: 0.91–1.98). A supplementary sibling-matched Cox regression analysis likewise suggested there was no excess risk of MS in persons delivered by C-section (HR = 1.03; 0.63–1.69).

Conclusions:

Mode of delivery appears to be unimportant in relation to MS development in the offspring.

Keywords

Multiple sclerosis immunology mode of delivery C-section offspring disease risk

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