Confounding in association studies: month of birth and multiple sclerosis.

a nominally significant excess in at least one spring month (March, April, May), and/or a nominally significant reduction in at least one winter month (November, December or January).

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Figure 2 shows that even within a country there is marked and highly significant heterogeneity in birth rate, with 99 % of records (437/440) for individual UK Government Office Regions being significantly different from that expected if birth rate were constant and 85 % of records (374/440) are significantly different from the average across all records from the corresponding region.

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