title: Increased risk of systemic lupus erythematosus in pregnancy-induced hypertension: A nationwide population-based retrospective cohort study.
abstract: Dysregulation of the immune system plays a role in the pathogenesis of both, pregnancy-induced hypertension (PIH) and systemic lupus erythematosus (SLE). It is well known that SLE predisposes to be complicated with PIH. However, few studies have attempted to investigate whether PIH increased subsequent SLE risk.The objectives of this study were to assess the association between PIH and subsequent SLE risk and identify predictive risk factors.Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD) and compared with a matched cohort without PIH based on age and the year of delivery. The incidence of new-onset SLE was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013.Among the 23.3 million individuals registered in the NHIRD, 29,091 patients with PIH and 116,364 matched controls were identified. The incidence of SLE was higher among patients with PIH than in the matched controls (incidence rate ratio [IRR] = 4.02, 95% confidence interval [CI] 3.98-4.05, P < 0.0001). The IRR for subsequent SLE development remained significantly higher in all stratifications during the follow-up years. The multivariate Cox regression model was performed and the results showed that PIH may be an independent risk factors for the development of subsequent SLE (hazard ratio [HR] = 2.87, 95% CI 2.07-3.98, P < 0.0001). Moreover, multivariate Cox regression model was used again among the PIH cohort only in order to identify the possible risk factors for subsequent SLE in the population with PIH.Patients with PIH may have higher risk of developing newly diagnosed SLE than those without PIH. In addition, among individuals who have experienced PIH, those younger than 30 years, having experienced preeclampsia/eclampsia, single parity, preterm birth, or chronic kidney disease, may display an increased subsequent risk of SLE.
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-sen University, Kaohsiung, Taiwan Division of Gynecology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan Department of Medical Research, China Medical University Hospital, Taichung, Taiwan Department of Gastroenterology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Section of Critical Care and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Li-Te
authors.initials: LT
authors.lastname: Lin
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Kuan-Hao
authors.initials: KH
authors.lastname: Tsui
authors.forename: Jiin-Tsuey
authors.initials: JT
authors.lastname: Cheng
authors.forename: Jin-Shiung
authors.initials: JS
authors.lastname: Cheng
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Huang
authors.forename: Pei-Ling
authors.initials: PL
authors.lastname: Tang
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Hu
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology*; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult