RESEARCH - Perinatal factors and adult-onset lupus

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Arthritis Rheum. 2008 Aug 15;59(8):1155-61.

Perinatal factors and adult-onset lupus.

Simard JF, Karlson EW, Costenbader KH, Hernán MA, Stampfer MJ, Liang

MH, Mittleman MA.

Harvard University and Beth Israel Deaconess Medical Center, Boston,

Massachusetts.

OBJECTIVE: Some evidence suggests that perinatal factors, including

birth weight and breastfeeding, may influence the occurrence of

autoimmune rheumatic diseases. However, few studies have investigated

these factors in patients with systemic lupus erythematosus (SLE).

Therefore, we evaluated the role of birth weight, being breastfed, and

preterm birth on the incidence of SLE in participants in the Nurses'

Health Study (NHS) and the Nurses' Health Study II (NHSII). METHODS:

We studied 87,411 NHS participants and 98,413 NHSII participants

without SLE at baseline who provided information on perinatal

exposures. Among these women, during 26 (NHS) and 14 (NHSII) years of

followup, 222 incident SLE cases were confirmed (136 NHS and 86 NHSII)

by medical record review using American College of Rheumatology

criteria. We used stratified models to estimate the association of

perinatal factors with SLE, adjusting for race, early passive

cigarette smoke exposure, and parents' occupation. A random-effects

meta-analysis was used to compute combined estimates across the 2

cohorts. RESULTS: After adjustment for multiple potential confounders,

high birth weight (>/=10 pounds) was associated with increased rates

of SLE compared with normal birth weight (7-8.5 pounds; rate ratio

[RR] 2.7, 95% confidence interval [95% CI] 1.2-5.9), as was being born

>/=2 weeks preterm (RR 1.9, 95% CI 1.2-3.0); however, being breastfed

was not (RR 0.8, 95% CI 0.6-1.1). CONCLUSION: Birth weight >/=10

pounds and preterm birth were both positively associated with incident

SLE among women.

PMID: 18668600

http://www.ncbi.nlm.nih.gov/pubmed/18668600

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