Caesarian section and MS

Epub ahead of printMaghzi et al. Cesarean delivery may increase the risk of multiple sclerosis. Mult Scler. 2011 Oct 7.

Background: Pregnancy related factors are believed to contribute to the risk of developing MS.

Objective: This study was designed to evaluate whether mode of delivery (vaginal versus cesarean section), as a perinatal factor, affects susceptibility to MS. 

Methods: MS'ers were recruited from the MS registry of Isfahan MS Society and were compared with their healthy siblings. Data regarding mode of delivery, birth order, and gestation week of birth were obtained through a specially designed questionnaire. Preterm or post term deliveries were excluded. 

Results: This study included 1349 participants (449 MS'ers and 900 controls). Subjects who were born by cesarean section had significant risk of MS (odds ratio, OR = 2.51; 95% confidence interval, CI: 1.43-4.41; p = 0.001). There was significant MS risk for females who were born by cesarean section (OR = 2.69, 95% CI: 1.30-5.58; p = 0.008), but not for males (OR = 2.25, 95% CI: 0.90-5.63; p = 0.082). The average age at onset was lower in MS'ers born by cesarean section (24.58 ± 6.33) compared to those born by vaginal delivery (27.59 ± 7.97; p = 0.041). There was no significant difference between the two groups for birth order. 

Conclusion: These results suggest that those born by vaginal delivery are at a lower risk of subsequent MS. These preliminary findings will need to be addressed in a much larger and preferably prospective study.

"An interesting observation that will need to confirmed. The best place to do this would be in Denmark or Sweden using their national databases."

"Now the million dollar question; how does caesarian section relate to MS risk? I suspect this may be an association. Could the factor or factors that predispose to MS risk in pregnancy also predispose to caesarian section? Any ideas?"

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