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Research ArticleSystemic Lupus Erythematosus

Gestational Diabetes Mellitus Risk in Pregnant Women With Systemic Lupus Erythematosus

Sofie A.M. Gernaat, Julia F. Simard, Anna-Karin Wikström, Elisabet Svenungsson and Elizabeth V. Arkema
The Journal of Rheumatology May 2022, 49 (5) 465-469; DOI: https://doi.org/10.3899/jrheum.210087
Sofie A.M. Gernaat
1S.A.M. Gernaat, MSc, PhD, E.V. Arkema, ScD, SM, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;
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Julia F. Simard
2J.F. Simard, ScD, SM, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden, and Division of Immunology and Rheumatology, Department of Medicine, Stanford School of Medicine, and Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, California, USA;
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Anna-Karin Wikström
3A.K. Wikström, MD, PhD, Department of Women´s and Children’s Health, Uppsala University, Uppsala, Sweden;
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Elisabet Svenungsson
4E. Svenungsson, MD, PhD, Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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Elizabeth V. Arkema
1S.A.M. Gernaat, MSc, PhD, E.V. Arkema, ScD, SM, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden;
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Abstract

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.

Key Indexing Terms:
  • gestational diabetes
  • glucocorticoids
  • pregnancy
  • systemic lupus erythematosus
  • Accepted for publication November 19, 2021.
  • Copyright © 2022 The Journal of Rheumatology. This is an Open Access article, which permits use, distribution, and reproduction, without modification, provided the original article is correctly cited and is not used for commercial purposes.
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1 May 2022
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Gestational Diabetes Mellitus Risk in Pregnant Women With Systemic Lupus Erythematosus
Sofie A.M. Gernaat, Julia F. Simard, Anna-Karin Wikström, Elisabet Svenungsson, Elizabeth V. Arkema
The Journal of Rheumatology May 2022, 49 (5) 465-469; DOI: 10.3899/jrheum.210087

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Gestational Diabetes Mellitus Risk in Pregnant Women With Systemic Lupus Erythematosus
Sofie A.M. Gernaat, Julia F. Simard, Anna-Karin Wikström, Elisabet Svenungsson, Elizabeth V. Arkema
The Journal of Rheumatology May 2022, 49 (5) 465-469; DOI: 10.3899/jrheum.210087
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Keywords

gestational diabetes
GLUCOCORTICOIDS
PREGNANCY
SYSTEMIC LUPUS ERYTHEMATOSUS

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  • gestational diabetes
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