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Perinatal factors and adult-onset lupus.
Arthritis Rheum 2008; 59(8):1155-61AR

Abstract

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 Cox 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 (> or =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 > or =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 > or =10 pounds and preterm birth were both positively associated with incident SLE among women.

Authors+Show Affiliations

Department of Epidemiology, Harvard University School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. julia.simard@post.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18668600

Citation

Simard, Julia F., et al. "Perinatal Factors and Adult-onset Lupus." Arthritis and Rheumatism, vol. 59, no. 8, 2008, pp. 1155-61.
Simard JF, Karlson EW, Costenbader KH, et al. Perinatal factors and adult-onset lupus. Arthritis Rheum. 2008;59(8):1155-61.
Simard, J. F., Karlson, E. W., Costenbader, K. H., Hernán, M. A., Stampfer, M. J., Liang, M. H., & Mittleman, M. A. (2008). Perinatal factors and adult-onset lupus. Arthritis and Rheumatism, 59(8), pp. 1155-61. doi:10.1002/art.23930.
Simard JF, et al. Perinatal Factors and Adult-onset Lupus. Arthritis Rheum. 2008 Aug 15;59(8):1155-61. PubMed PMID: 18668600.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perinatal factors and adult-onset lupus. AU - Simard,Julia F, AU - Karlson,Elizabeth W, AU - Costenbader,Karen H, AU - Hernán,Miguel A, AU - Stampfer,Meir J, AU - Liang,Matthew H, AU - Mittleman,Murray A, PY - 2008/8/1/pubmed PY - 2008/9/19/medline PY - 2008/8/1/entrez SP - 1155 EP - 61 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 59 IS - 8 N2 - 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 Cox 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 (> or =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 > or =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 > or =10 pounds and preterm birth were both positively associated with incident SLE among women. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/18668600/Perinatal_factors_and_adult_onset_lupus_ L2 - https://doi.org/10.1002/art.23930 DB - PRIME DP - Unbound Medicine ER -