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Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study.

Publication ,  Journal Article
Cooper, GS; Dooley, MA; Treadwell, EL; St Clair, EW; Gilkeson, GS
Published in: Arthritis Rheum
July 2002

OBJECTIVE: Estrogen and prolactin may accelerate the progression of murine systemic lupus erythematosus (SLE). In humans, 85% of lupus patients are women, which also suggests the importance of hormonal factors in disease pathogenesis. The purpose of this study was to examine hormonal and reproductive risk factors for lupus among women. METHODS: This population-based, case-control study included 240 female SLE patients diagnosed between January 1, 1995 and July 31, 1999 who fulfilled the American College of Rheumatology classification criteria. Female controls (n = 321) were identified through driver's license records. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) as measures of association, adjusting for age, state, race, and education. Analyses were limited to exposures before diagnosis. RESULTS: Breast-feeding was associated with a decreased risk of developing SLE (OR 0.6, 95% CI 0.4-0.9), with a statistically significant trend for number of babies breast-fed and total weeks of breast-feeding. There were no associations with number of pregnancies or live births. Natural menopause occurred earlier in women with subsequent development of SLE compared with controls (P < 0.001). There was little association between SLE and current use or duration of use of hormone replacement therapy or oral contraceptives, and no association with previous use of fertility drugs. CONCLUSION: We found little evidence that estrogen- or prolactin-related exposures are associated with an increased risk of lupus. The reduced risk observed among women who had breast-fed one or more babies should be examined in other studies. Early natural menopause, rather than decreasing risk of SLE because of reduced estrogen exposure, may be a marker of susceptibility to development of SLE.

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Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

July 2002

Volume

46

Issue

7

Start / End Page

1830 / 1839

Location

United States

Related Subject Headings

  • Risk Factors
  • Prolactin
  • Pregnancy
  • Odds Ratio
  • Middle Aged
  • Menstruation
  • Menopause
  • Lupus Erythematosus, Systemic
  • Humans
  • Hormone Replacement Therapy
 

Citation

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Chicago
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Cooper, G. S., Dooley, M. A., Treadwell, E. L., St Clair, E. W., & Gilkeson, G. S. (2002). Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study. Arthritis Rheum, 46(7), 1830–1839. https://doi.org/10.1002/art.10365
Cooper, Glinda S., Mary Anne Dooley, Edward L. Treadwell, E William St Clair, and Gary S. Gilkeson. “Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study.Arthritis Rheum 46, no. 7 (July 2002): 1830–39. https://doi.org/10.1002/art.10365.
Cooper GS, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS. Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study. Arthritis Rheum. 2002 Jul;46(7):1830–9.
Cooper, Glinda S., et al. “Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study.Arthritis Rheum, vol. 46, no. 7, July 2002, pp. 1830–39. Pubmed, doi:10.1002/art.10365.
Cooper GS, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS. Hormonal and reproductive risk factors for development of systemic lupus erythematosus: results of a population-based, case-control study. Arthritis Rheum. 2002 Jul;46(7):1830–1839.
Journal cover image

Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

July 2002

Volume

46

Issue

7

Start / End Page

1830 / 1839

Location

United States

Related Subject Headings

  • Risk Factors
  • Prolactin
  • Pregnancy
  • Odds Ratio
  • Middle Aged
  • Menstruation
  • Menopause
  • Lupus Erythematosus, Systemic
  • Humans
  • Hormone Replacement Therapy