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Childhood and Adolescent Environmental Risk Factors for Multiple Sclerosis: A Systematic Review With Meta-Analysis.

Bruno Kusznir Vitturi1, Maria Cellerino2, Daniele Boccia2

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European Journal of Neurology
|October 28, 2025
PubMed
Summary
This summary is machine-generated.

Childhood environmental exposures like infections, smoking, and obesity significantly increase multiple sclerosis (MS) risk. Early life prevention is crucial for reducing MS incidence.

Keywords:
demyelinating diseasesenvironmental exposuremultiple sclerosisrisk factors

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Area of Science:

  • Pediatric Environmental Health
  • Neuroepidemiology

Background:

  • Multiple sclerosis (MS) etiology involves complex interactions between genetic and environmental factors.
  • Identifying pediatric environmental risk factors is crucial for understanding MS development and informing prevention strategies.

Purpose of the Study:

  • To synthesize current evidence on pediatric environmental exposures linked to multiple sclerosis (MS) risk.
  • To provide an updated literature review on environmental determinants of MS in early life.

Main Methods:

  • Systematic literature search across PubMed, SciVerse ScienceDirect, and Web of Science.
  • Inclusion of clinical studies assessing MS occurrence in relation to childhood/adolescent environmental exposures.
  • Meta-analysis of pooled unadjusted effect sizes (OR) with random-effects models.

Main Results:

  • Analysis of 87 studies revealed significant associations between pediatric exposures and MS risk.
  • Epstein-Barr virus (EBV) infection showed a strong positive association (ES=2.38).
  • Factors like childhood smoking, obesity, antibiotic/chemical exposures, and vitamin D deficiency were linked to increased MS risk, while breastfeeding showed limited protection.

Conclusions:

  • Childhood and adolescence represent critical windows for MS development influenced by environmental factors.
  • The first two decades of life offer a key opportunity for MS prevention through targeted interventions.