儿科多发性硬化症的早期逆境和社会经济因素:一个病例对照研究
Sarah K G Jensen1, Susana Camposano1, Anne Berens1
1From the Pediatric Multiple Sclerosis and Related Disorders Program (S.K.G.J., S.C., L.A.B., M.P.G.), Department of Neurology, Boston Children's Hospital, Harvard Medical School; Boston College (S.K.G.J.), School of Social Work, MA; Stanford University School of Medicine (A.B.), Palo Alto, CA; Department of Pediatrics (M.W., T.C.C.), University of Utah, Salt Lake City; Pediatric Multiple Sclerosis Center (L.B.K., L.C., A.L.B.), NYU Grossman School of Medicine, New York; Pediatric Multiple Sclerosis Center at Loma Linda University Children's Hospital (G.S.A.), Loma Linda University, CA; Primary Children's Hospital (M.C.), University of Utah, Salt Lake City; Division of Child Neurology (T.C.), Department of Neurology, Massachusetts General Hospital, Boston; UCSD Pediatric MS Center (J.G.), San Diego, CA; Center for Pediatric-Onset Demyelinating Disease at the Children's of Alabama (Y.S.W.), University of Alabama, Birmingham; Children's National Medical Center (I.K.), Washington, DC; Baylor College of Medicine (T.E.L.), Houston, TX; Washington University Pediatric MS and other Demyelinating Disease Center (S.S.M.), Washington University in St. Louis, MO; Mellen Center for Multiple Sclerosis (M. Rensel), Cleveland Clinic, OH; Mayo Clinic (M. Rodriguez, J.-M.T.), Rochester, MN; Department of Neurology (J.W.R.), University of Utah, Salt Lake City; Ann and Robert H. Lurie Children's Hospital of Chicago (J.P.R.), IL; Division of Neurology (A.T.W.), Children's Hospital of Philadelphia, PA; The Pediatric MS Center at the Jacobs Neurological Institute (B.W.-G.), State University of New York at Buffalo; Division of Epidemiology and Genetic Epidemiology and Genomics Laboratory (L.F.B.), School of Public Health, University of California Berkeley; and UCSF Weill Institute for Neurosciences (E.W.), University of California San Francisco.
社区社会经济劣势增加了儿科发病多发性硬化症 (MS) 风险,而更高的家长教育可能有保护作用. 需要进一步的研究来探索其他童年逆境及其对儿科MS的影响.
科学领域:
- 神经免疫学 神经免疫学
- 儿科神经学 儿科神经学
- 环境流行病学环境流行病学
背景情况:
- 童年社会经济劣势与心理社会逆境和压力有关.
- 这些因素可以导致神经毒性和炎症,可能会增加患多发性硬化症 (MS) 等神经退行性疾病的风险.
- 儿科发病性MS (POMS) 可能受到这些早期生活环境因素的影响.
研究的目的:
- 调查社会经济劣势和心理社会逆境与POMS风险之间的关联.
- 检查这些因素与POMS疾病活动之间的关系,包括发病时的年龄和残疾.
- 为了确定保护因素,如父母的高等教育,对POMS.
主要方法:
- 一项病例控制研究,涉及381例POMS病例和611名年龄在3至21岁之间的对照.
- 从美国17个地点收集的数据,通过问卷和邮政编码数据评估产前/产后逆境和社会经济因素.
- 主要结局:MS诊断;次要结局:发病时的年龄,复发率和扩展残疾状态量表 (EDSS).
主要成果:
- 较低的母亲教育 (低于学士学位) 与增加的POMS几率 (OR 0.42) 相关.
- 较高的童年社区劣势分数与增加的POMS风险相关 (或每点1.04).
- 在社会经济变量或产前/产后逆境与POMS发病年龄,复发率或EDSS之间没有发现显著的关联.
结论:
- 社区层面的社会经济地位似乎是POMS的重要风险因素.
- 高等的家长教育可能会对防止POMS的发展产生保护作用.
- 未来的研究应该调查更广泛的童年压力因素及其对POMS发展的影响.
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