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.
Keywords: gestational diabetes; glucocorticoids; pregnancy; systemic lupus erythematosus.
© 2022 by the Journal of Rheumatology.