%0 Journal Article %A Candace H. Feldman %A Susan Malspeis %A Cianna Leatherwood %A Laura Kubzansky %A Karen H. Costenbader %A Andrea L. Roberts %T Association of Childhood Abuse with Incident Systemic Lupus Erythematosus in Adulthood in a Longitudinal Cohort of Women %D 2019 %R 10.3899/jrheum.190009 %J The Journal of Rheumatology %P jrheum.190009 %X Objective Exposure to severe stressors may alter immune function and augment inflammation and cytokine release, increasing autoimmune disease risk. We examined if childhood abuse was associated with heightened risk of incident systemic lupus erythematosus (SLE). Methods Data were from the Nurses’ Health Study II, a cohort of U.S. female nurses enrolled in 1989, followed with biennial questionnaires. We measured childhood physical and emotional abuse with the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire and sexual abuse with the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale, both administered in 2001. We identified incident SLE (>4 American College of Rheumatology 1997 classification criteria) through 2015. We used multivariable Cox regression models to evaluate the association between childhood abuse and SLE accounting for potential confounders (e.g. parental education, occupation, home ownership) and mediators (e.g. depression, posttraumatic stress disorder (PTSD)). Results Among 67,516 women, there were 94 incident SLE cases. In adjusted models, exposure to the highest vs. lowest physical and emotional abuse was associated with 2.57 times greater risk of SLE (95% CI 1.30-5.12). We found that 17% (p<0.0001) of SLE risk associated with abuse could be explained by depression and 23% (p<0.0001) by PTSD. We did not observe a statistically significant association with sexual abuse (HR 0.84, 95% CI 0.40-1.77, highest vs. lowest exposure). Conclusion We observed significantly increased risk of SLE among women who experienced childhood physical and emotional abuse compared with women who had not. Exposure to childhood adversity may contribute to SLE development. %U https://www.jrheum.org/content/jrheum/early/2019/05/13/jrheum.190009.full.pdf