Journal
JOURNAL OF RHEUMATOLOGY
Volume 49, Issue 5, Pages 465-469Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.210087
Keywords
gestational diabetes; glucocorticoids; pregnancy; systemic lupus erythematosus
Categories
Funding
- Ingegerd Johansson Donation Project Grant [SLS-714651]
- National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases [R01 AR077103-01]
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The study found a risk association between systemic lupus erythematosus (SLE) and gestational diabetes mellitus (GDM), with women with SLE being more likely to develop GDM during pregnancy compared to general population controls.
Objective. To investigate the risk of gestational diabetes mellitus (GDM) associated with systemic lupus erythematosus (SLE) by comparing pregnancies in women with SLE to general population controls. Methods. We identified singleton pregnancies among women with SLE and general population controls in the Swedish Medical Birth Register (MBR; 2006???2016), sampled from the population-based Swedish Lupus Linkage (SLINK) cohort (1987???2012). SLE was defined by >_ 2 International Classification of Diseases (ICD)-coded visits in the National Patient Register (NPR) and MBR, with >_ 1 visit before pregnancy. GDM was defined by >_ 1 ICD-coded visit in the NPR or MBR. Glucocorticoid (GC) and hydroxychloroquine (HCQ) dispensations within 6 months before and during pregnancy were identified in the Prescribed Drug Register. Risk ratios (RRs) and 95% CIs of GDM associated with SLE were estimated using modified Poisson regression models, stratified by parity and adjusted for maternal age at delivery, year of birth, and obesity. Results. We identified 695 SLE pregnancies including 18 (2.6%) with GDM and 4644 non-SLE pregnancies including 65 (1.4%) with GDM. Adjusted RRs of GDM associated with SLE were 1.11 (95% CI 0.38???3.27) for first deliveries and 2.03 (95% CI 1.21???3.40) for all deliveries. Among SLE pregnancies, GDM occurred in 7/306 (2.3%) with >_ 1 GC before and/or during pregnancy, 11/389 (2.8%) without GC, 7/287 (2.4%) with >_ 1 HCQ before and/or during pregnancy, and in 11/408 (2.7%) without HCQ. Conclusion. When looking at all deliveries, SLE was associated with a 2-fold higher risk of GDM. GDM occurrence did not differ by GC or HCQ.
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