{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:16:26Z","timestamp":1777936586627,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2013,3,6]],"date-time":"2013-03-06T00:00:00Z","timestamp":1362528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We studied the association between C-section and risk of MS, in a cohort of 1.7 million Danes born from 1973 to 2005.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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\u20131.46). Analyses stratified by sex revealed no unusual risk of MS for women (RR = 1.08: 0.80\u20131.42) nor men (RR = 1.37: 0.91\u20131.98). 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\u20131.69).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Mode of delivery appears to be unimportant in relation to MS development in the offspring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458513480010","type":"journal-article","created":{"date-parts":[[2013,3,6]],"date-time":"2013-03-06T21:28:50Z","timestamp":1362605330000},"page":"1473-1477","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Cesarean section and offspring\u2019s risk of multiple sclerosis: a Danish nationwide cohort study"],"prefix":"10.1177","volume":"19","author":[{"given":"Nete M","family":"Nielsen","sequence":"first","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Bager","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egon","family":"Stenager","sequence":"additional","affiliation":[{"name":"The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark"},{"name":"Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark"},{"name":"Multiple Sclerosis Clinic of Southern Jutland, Department of Neurology, S\u00f8nderborg, Denmark"},{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo V","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nils","family":"Koch-Henriksen","sequence":"additional","affiliation":[{"name":"The Danish Multiple Sclerosis Registry, Rigshospitalet, Copenhagen, Denmark"},{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Hjalgrim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Frisch","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,3,6]]},"reference":[{"key":"bibr1-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70064-8"},{"key":"bibr2-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7319.951a"},{"key":"bibr3-1352458513480010","first-page":"4421","volume":"165","author":"Hornnes PJ","year":"2003","journal-title":"Ugeskr Laeger"},{"key":"bibr4-1352458513480010","unstructured":"Tal og analyse: F\u00f8dselsstatistikken 2011. Sundhedsstyrelsen 2012, The Danish National Board of Health, www.sst.dk."},{"key":"bibr5-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2003.01667.x"},{"key":"bibr6-1352458513480010","doi-asserted-by":"publisher","DOI":"10.2174\/138920009787048437"},{"key":"bibr7-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2008.02939.x"},{"key":"bibr8-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21805"},{"key":"bibr9-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0941-z"},{"key":"bibr10-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2010.03611.x"},{"key":"bibr11-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511424904"},{"key":"bibr12-1352458513480010","first-page":"441","volume":"53","author":"Pedersen CB","year":"2006","journal-title":"Dan Med Bull"},{"key":"bibr13-1352458513480010","first-page":"320","volume":"45","author":"Knudsen LB","year":"1998","journal-title":"Dan Med Bull"},{"key":"bibr14-1352458513480010","first-page":"91","volume":"48","author":"Koch-Henriksen N","year":"2001","journal-title":"Dan Med Bull"},{"key":"bibr15-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2011.01558.x"},{"key":"bibr16-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"bibr17-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.9.875"},{"key":"bibr18-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/152.3.197"},{"key":"bibr19-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2007.06.012"},{"key":"bibr20-1352458513480010","first-page":"251","volume":"14","author":"Vaknin-Dembinsky A","year":"2012","journal-title":"Isr Med Assoc J"},{"key":"bibr21-1352458513480010","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2009.07.016"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458513480010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1352458513480010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458513480010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:37:08Z","timestamp":1777693028000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1352458513480010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,6]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1177\/1352458513480010"],"URL":"https:\/\/doi.org\/10.1177\/1352458513480010","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,6]]}}}