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

Mult Scler. 2013 Oct;19(11):1473-7. doi: 10.1177/1352458513480010. Epub 2013 Mar 6.


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

MeSH terms

  • Cesarean Section / adverse effects*
  • Cohort Studies
  • Denmark / epidemiology
  • Female
  • Humans
  • Male
  • Multiple Sclerosis / epidemiology*
  • Pregnancy
  • Proportional Hazards Models
  • Risk Factors