Women who experienced childhood sexual and emotional abuse may have an increased risk of developing multiple sclerosis (MS) later in life, according to study findings published in Journal of Neurology, Neurosurgery, and Psychiatry.

A Swedish study suggested major stressors in adult life are associated with future MS, and adverse childhood experiences (ACES) have been shown to increase the risk of psychiatric and physical disorders among adults. Few studies have examined whether child abuse and MS are linked. The current researchers sought to examine whether ACES may increase the risk for MS. This is the first fully prospective study to analyze the connection between childhood adverse events and subsequent MS, according to the researchers.

Forty-one percent of the Norwegian Mother, Father, and Child cohort (MoBa) of pregnant Norwegian women enrolled in the current study. Women self-reported their demographic and socioeconomic factors and history of abuse. The researchers excluded women who were diagnosed with MS in the same year they enrolled in the study or who had been diagnosed with MS at study baseline. MS diagnosis was cross-linked in the Norwegian MS registry and hospital records.


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Of the 77,997 women from the MoBa cohort included in the study, 14,477 women (19%) had been exposed to ACES. The women with exposure to childhood abuse were more likely to have a history of smoking, be overweight, and have more depression at baseline.

A total of 300 women developed MS during follow-up; 24% of these women reported history of child abuse; and 19% of women who did not develop MS reported history of child abuse.

Exposure to emotional (HR 1.40 (95% CI, 1.03-1.90) or sexual abuse (HR 1.65 (95% CI 1.13-2.39) was associated with subsequent MS development after adjusting for confounders and accounting for possible mediators. Physical abuse exposure was associated with a similar HR as exposure to any type of childhood abuse (HR 1.31 for both) (physical abuse 95% CI, 0.83-2.06) and any childhood abuse (95% CI, 0.99-1.72), fully adjusted analysis found.

Risk of MS was higher among women who were exposed to 2 (HR 1.66, 95% CI 1.04-2.67) or all 3 categories of childhood abuse (HR 1.93 95% CI 1.02-3.67).

When the researchers excluded women who could have been in a prodromal phase of MS when they experienced abuse, they found similar or stronger associations between the abuse and MS (sexual abuse HR 1.77 (95% CI, 1.22-2.57) emotional abuse 1.40 (95% CI, 1.01-1.95)).

Study limitations included external validity, residual confounding, self-report of childhood abuse, and lack of information on chronicity of abuse.

“Childhood sexual and emotional abuse were associated with an increased risk of developing MS,” the researchers noted. “The risk was higher when exposed to several abuse categories, indicating a dose–response relationship.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Eid K, Torkildsen Ø, Aarseth J, et al. Association of adverse childhood experiences with the development of multiple sclerosis. J Neurol Neurosurg Psychiatry. Published online April 4, 2022. doi:10.1136/jnnp-2021-328700



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