Citation

Cozier YC, Barbhaiya M, Castro-Webb N, Conte C, Tedeschi S, Leatherwood C, Costenbader KH, Rosenberg L. Arthritis Care Res. (2010) 2020; ePub(ePub): ePub.

Affiliation

Slone Epidemiology Center, Boston University, Boston, MA, United States.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1002/acr.24188

PMID

32170851

Abstract

OBJECTIVE: Exposure to psychosocial stressors may contribute to the onset of systemic lupus erythematosus (SLE) through dysregulation of the adaptive stress response. We assessed the relationship of childhood physical and sexual abuse to SLE risk among Black women.

METHODS: Using data from the Black Women's Health Study, we followed 36,152 women from 1995 through 2015 with biennial questionnaires. Women reported on exposure to abuse during childhood (up to age 11) in 2005. Self-reported incident SLE cases were confirmed as meeting American College of Rheumatology SLE classification criteria by medical record review. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for SLE among women exposed to physical or sexual abuse during childhood, controlling for potential confounders.

RESULTS: We confirmed 101 cases of incident SLE who had completed the child abuse questions, during 670,822 person-years of follow-up. Both physical and sexual abuse during childhood were associated with statistically significant increases in SLE incidence. The HR for SLE associated with ≥ 2 episodes of severe sexual abuse compared to no abuse was 2.51 (95% CI 1.29-4.85) after adjustment for alcohol consumption, smoking, body mass index, oral contraceptive use, age at menarche, and parental education. The multivariable-adjusted HR for SLE with ≥ 5 episodes of severe physical abuse was 2.37 (1.13-4.99).

CONCLUSION: Our results suggest that sexual and physical abuse during childhood increase SLE risk during adulthood among Black women. Research is necessary both to confirm this finding and to understand potential mediating mechanisms.

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Language: en