Impact of parental multiple sclerosis and the associated mental comorbidity on early childhood development in Manitoba, Canada
METHODS: Retrospective matched cohort study in Manitoba, Canada, using linked population-based administrative databases. Of 49,328 children who were part of the Early Development Instrument data (EDI) collection, and born between 1999 and 2006, those with an MS parent were compared to children matched from the general population. MS and mental comorbidity were identified through validated algorithms using health administrative data. Developmental outcomes included the 5 EDI domains: physical health, social competence, emotional maturity, language and cognitive, and communication skills. Findings are expressed as adjusted odds ratios (aOR) from multivariable conditional logistic regression models adjusting for confounders.
RESULTS: Overall, 153 children had an MS parent and 888 formed the matched cohort. Children with an MS parent were similar to the matched population on all EDI domains, except vulnerability in social competence (aOR 0.50;95%CI:0.25-0.97). However, mental comorbidity affected more MS parents compared to the general population (77/153 [50.3%] vs. 313/888 [35.3%],P<0.001). Compared to unaffected MS parents, those with mental comorbidity were more likely to have a child who was vulnerable on the social competence (aOR 5.33;95%CI:1.12–25.44) or emotional maturity (aOR 3.11;95%CI:1.10–8.77) domains.
CONCLUSIONS: The presence of parental MS was not independently associated with adverse developmental outcomes in children. However, mental comorbidity was more common in MS parents and had a detrimental impact on development. Health professionals need to be aware of the impact of mental health in MS on childhood development and help to improve outcomes for this potentially ‘at risk’ children.