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Association between perinatal factors and future risk for gout-a nested case-control study
Mats Dehlin1, Lennart T H Jacobsson2
1Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, S-413 45, Göteborg, Sweden. mats.dehlin@gu.se.
Insights
Maternal diabetes and being small for gestational age during pregnancy significantly increase the risk of developing gout later in life. These factors may contribute to the rising prevalence of gout.
Area of Science:
- Reproductive health
- Metabolic disease epidemiology
- Gout pathogenesis
Background:
- Elevated serum urate is a primary risk factor for gout, but not all hyperuricemic individuals develop gout.
- Low birth weight is linked to conditions like diabetes and renal disease, which can cause hyperuricemia.
- Investigating maternal and perinatal factors may reveal additional gout risk predictors.
Purpose of the Study:
- To determine the association between maternal and perinatal factors and the future risk of gout diagnosis.
- To assess the extent to which birth weight influences the likelihood of developing gout.
- To explore the role of maternal health and gestational conditions in gout development.
Main Methods:
- A population-based retrospective nested case-control study using Swedish health registers.
- Included incident gout cases (born 1973 onwards, diagnosed 2000-2019) and matched controls.
- Analyzed maternal health, gestational length, birth weight, congenital malformations, and number of siblings.
Main Results:
- Maternal diabetes significantly increased gout risk (OR 3.1, 95% CI 1.3-7.4, p=0.01).
- Congenital malformations showed a moderate increase in gout risk (OR 1.33, 95% CI 1.04-1.7, p=0.02).
- Being small for gestational age strongly elevated future gout risk (OR 1.75, 95% CI 1.3-2.3, p<0.0001).
Conclusions:
- Maternal diabetes and being small for gestational age are significant risk factors for developing gout in young adults.
- The increasing prevalence of these conditions may fuel the ongoing gout epidemic.
- Further research is needed to confirm these findings and elucidate the underlying biological mechanisms.
Background:
Increased level of urate is the strongest risk factor for gout development but since only a minority of hyperuricemics are affected by gout, other pathogenic factors must be considered. Low birth weight is associated with future morbidities causing hyperuricemia, such as diabetes and renal disease. The purpose of this study was to investigate if, and to what extent, maternal and perinatal factors, including birth weight, are associated with future risk of being diagnosed with gout.
Methods:
A population-based retrospective nested case-control registry study based on regional and national health care registers in Sweden. All incident cases of gout born in 1973 and onward who had received ≥1 diagnosis of gout from 2000 through 2019 in the region of western Sweden were included. Up to 5 non-gout controls were matched to each case by age, sex, and county at the year of first gout diagnosis. A range of maternal, gestational, and perinatal factors were analyzed for their potential association to future gout development. This included the health of the mother, gestational length, birth weight, number of siblings, and congenital malformations.
Results:
Maternal diabetes, any congenital malformation, and being small for gestational age were factors that significantly increased the risk for future gout development, odds ratio (95% CI) 3.1 (1.3 to 7.4) (p=0.01), 1.33 (1.04 to 1.7) (p=0.02), and 1.75 (1.3 to 2.3) (p<.0001), respectively.
Conclusions:
In this study, maternal diabetes and being small for gestational age increased the risk for future gout development in young adults. As of today, these conditions are becoming more prevalent and may contribute to the ongoing gout epidemic. These results require both confirmation and further delineation of underlying mechanisms.
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