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Introduction <p>Sun exposure may influence MS susceptibility, but evidence in pediatric-onset MS (PedMS) is limited. We examined whether reduced early-childhood outdoor time (a proxy for lower sun exposure) is associated with PedMS risk.</p> Methods <p>In the Italian multicenter PEDIGREE Study, environmental data were collected using the PEQ-IT questionnaire. We enrolled individuals &lt; 18&#xa0;years with PedMS and disease duration ≤ 5&#xa0;years and controls without CNS inflammatory disorders. Outdoor time was reported by season and age (0–1, 1–2, 3–5&#xa0;years); reduced activity was defined as &lt; 60&#xa0;min/week.</p> Results <p>We included 114 PedMS cases and 121 controls. Cases were 77.2% female; mean (SD) age 16.8 (2.7) years; mean (SD) age at onset 14.2 (2.6) years; median EDSS 1.0 (range 0–4.0). Associations were strongest in winter: reduced outdoor time was associated with higher odds of PedMS in the first year (adjOR 3.02, 95%CI 1.50–6.08), ages 1–2 (adjOR 2.72, 95%CI 1.45–5.09), and ages 3–5 (adjOR 2.66, 95%CI 1.40–5.07). Across ages 0–5, low winter outdoor activity remained strongly associated (adjOR 4.30, 95%CI 1.82–10.17). Other seasons showed weaker but overall significant trends.</p> Conclusion <p>Limited early-childhood outdoor activity may be associated with increased PedMS risk; larger longitudinal studies are needed.</p>

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Reduced Childhood Outdoor Exposure Raises Pediatric Multiple Sclerosis (PedMS) Risk

  • 期刊论文

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  • 发表日期：

    2026年5月24日

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  • Silvy Pilotto,
  • Angelo Ghezzi,
  • Stefania Maria Bova,
  • Marzia Fronza,
  • Pietro Annovazzi,
  • Marta Simone,
  • Antonio Gallo,
  • Agnese Suppiej,
  • Roberta Lanzillo,
  • Sarah Rasia,
  • Angela Berardinelli,
  • Valentina Torri Clerici,
  • Lucia Moiola,
  • Maurizio Viri,
  • Stefano Sotgiu,
  • Simona Malucchi,
  • Alessandra Protti,
  • Carlotta Canavese,
  • Giacomo Lus,
  • Luigi M. E. Grimaldi,
  • Marta Zaffira Conti,
  • Giovanna Borriello,
  • Giovanna De Luca,
  • Valentina Tomassini,
  • Alberto Priori,
  • Martina Tosi,
  • Nicola Pomella,
  • Andrea Corona,
  • Alen Zollo,
  • Maria Pia Amato,
  • Eleonora Cocco,
  • Maria Trojano,
  • Filippo Martinelli-Boneschi,
  • Sandra D’Alfonso,
  • Roberto Bergamaschi,
  • Maura Pugliatti

摘要

Introduction

Sun exposure may influence MS susceptibility, but evidence in pediatric-onset MS (PedMS) is limited. We examined whether reduced early-childhood outdoor time (a proxy for lower sun exposure) is associated with PedMS risk.

Methods

In the Italian multicenter PEDIGREE Study, environmental data were collected using the PEQ-IT questionnaire. We enrolled individuals < 18 years with PedMS and disease duration ≤ 5 years and controls without CNS inflammatory disorders. Outdoor time was reported by season and age (0–1, 1–2, 3–5 years); reduced activity was defined as < 60 min/week.

Results

We included 114 PedMS cases and 121 controls. Cases were 77.2% female; mean (SD) age 16.8 (2.7) years; mean (SD) age at onset 14.2 (2.6) years; median EDSS 1.0 (range 0–4.0). Associations were strongest in winter: reduced outdoor time was associated with higher odds of PedMS in the first year (adjOR 3.02, 95%CI 1.50–6.08), ages 1–2 (adjOR 2.72, 95%CI 1.45–5.09), and ages 3–5 (adjOR 2.66, 95%CI 1.40–5.07). Across ages 0–5, low winter outdoor activity remained strongly associated (adjOR 4.30, 95%CI 1.82–10.17). Other seasons showed weaker but overall significant trends.

Conclusion

Limited early-childhood outdoor activity may be associated with increased PedMS risk; larger longitudinal studies are needed.