Childhood Abuse Puts Women at Greater Risk of Lupus Later in Life, Study Suggests

Women who were victims of physical or emotional abuse during childhood are at a higher risk of developing systemic lupus erythematosus (SLE) later in life, a retrospective study reports.

According to the findings, exposure to extreme childhood stress and adversity may contribute to the development of the disease. The results justify further studies to investigate why and how the timing and socioenvironmental context of such abuse influence the appearance of the disease.

The study, “Association of Exposure to Childhood Abuse with Incident Systemic Lupus Erythematosus in a Longitudinal Cohort of Women,” was recently presented at the American College of Rheumatology/Association of Reproductive Health Professionals 2018 Annual Meeting in Chicago.

The results were presented by Candace H. Feldman, MD, a rheumatologist affiliated with Brigham and Women’s Hospital and Harvard Medical School.

To investigate the correlation between childhood physical, emotional, and sexual abuse and the incidence of lupus, Feldman and her colleagues used data from one of the largest studies on risk factors for chronic diseases in women — the Nurses’ Health Study II. This study is part of a broader project that has been following health and lifestyle factors of thousands of male and female nurses in the U.S. since 1976.

The current study included 67,434 women enrolled in the registry, who were at a mean age of 34.6 years in 1989 and had been followed for more than 24 years. Participants completed surveys every two years.

Researchers used specific questionnaire-based scales to determine the level of physical, emotional, and sexual abuse experienced by the participants as a child.

Physical and emotional abuse questionnaires surveyed participants on how often they had experienced physical abuse or psychological maltreatment such as yelling, screaming, or insults from a family member. Surveys for physical assault and sexual abuse asked participants about episodes of forced sexual activity by either adults or older children.

Of the 67,434 women studied, 93 women developed SLE over the follow-up period.

After accounting for age and race, which could potentially alter the results, researchers found that women who experienced the highest levels of physical and emotional mistreatment in their childhood were more than twice (2.21 times) as likely to develop lupus as those who had experienced the lowest levels of abuse.

Moreover, women who had experienced moderate to high levels of physical assault early in life had a 1.7 times higher risk of developing SLE than those who were not victims of such abuse.

However, there was no significant association between sexual abuse and SLE risk.

According to the meeting’s abstract, the researchers concluded that there was a “significantly increased risk of incident SLE among women who experienced childhood physical and emotional abuse, compared with women who had not.”

“Our findings suggest that exposure to extreme childhood stress and adversity may contribute to SLE development,” they added.

The team emphasized that further studies are needed to investigate the impact of timing and the underlying mechanisms of abuse experiences in the development of disease such as lupus.