Association Between Sun Exposure and Risk of Relapse in Pediatric-Onset Multiple Sclerosis.

Other significant or near-significant factors associated with increased risk of relapse in this model were summer birth season (aHR 1.63, CI 1.09–2.44, p = 0.02; compared with winter birth season) and treatment with mid-efficacy DMT (aHR 1.82, CI 0.93–3.55, p = 0.08; compared with no DMT use) or high-efficacy DMT (aHR 1.83, 0.92–3.64, p = 0.08; compared with no DMT use) (eTable 1, model 1).

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While it did not reach statistical significance on multivariable analysis, our finding of the protective effect of greater UVR exposure in the 6 months before birth (which would correspond to the second trimester) further supports this finding, through a more direct measurement of sun exposure.

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