According to research presented at the annual meeting, women who experienced physical or emotional abuse in childhood have a significantly higher risk of developing systemic lupus erythematosus (SLE) in adulthood.
SLE is a chronic disease that causes systemic inflammation that affects multiple organs. It is far more common in women than men. Past research has shown associations between post-traumatic stress disorder and increased risk of SLE, as well as between childhood adverse events and higher risk for hospitalization due to autoimmune disease. Therefore, researchers from Brigham and Women’s Hospital/Harvard Medical School and the Harvard T.H. Chan School of Public Health in Boston examined correlations between childhood abuse and SLE risk.
The research team examined data on 67,434 women from the Nurses’ Health Study II, a longitudinal cohort of female nurses in the United States. The researchers assessed whether the nurses had experienced physical abuse, emotional maltreatment, or sexual abuse in childhood, per the nurses’ completion in 2001 of the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire, the Conflict Tactics Scale, and the Sexual Maltreatment Scale of the Parent-Child Conflicts Tactics Scale.
The researchers then identified new SLE cases among the cohort through 2015 via self-report of physician diagnoses, which then were confirmed by two rheumatologists via medical record review. Finally, the researchers evaluated the association between childhood abuse and risk of developing SLE, accounting for potential confounders and other risk factors, such as smoking, body mass index, and parents’ socioeconomic status.
There were 93 cases of SLE. Patients who were exposed to the highest levels of physical and emotional abuse had a more than twofold greater risk of developing SLE compared with patients who were exposed to the lowest levels of such abuse. Those who were exposed to moderate or high levels of physical assault had a 1.70 times higher risk of SLE compared with those who had no exposure to assault. The research did not find a statistically significant association between sexual abuse and risk of SLE.
“The strong association observed between childhood abuse and lupus risk suggests the need for further research to understand biological and behavioral changes triggered by stress combined with other environmental exposures,” said lead author Candace H. Feldman, MD, ScD, of Harvard Medical School. “In addition, physicians should consider screening their patients for experiences of childhood abuse and trauma.”