RT Journal Article
SR Electronic
T1 Gestational Diabetes Mellitus Risk in Pregnant Women with Systemic Lupus Erythematosus
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.210087
DO 10.3899/jrheum.210087
A1 Sofie A.M.  Gernaat
A1 Julia F.  Simard
A1 Anna-Karin Wikström
A1 Elisabet Svenungsson
A1 Elizabeth V.  Arkema
YR 2021
UL http://www.jrheum.org/content/early/2021/11/25/jrheum.210087.abstract
AB 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 populationbased register linkage SLINK (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 6 months before and during pregnancy were identified in the Prescribed Drug Register. Risk ratios and 95% confidence intervals (RRs; 95% CI) 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 4,644 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 two-fold higher risk of GDM. GDM occurrence did not differ by GC or HCQ.