Nationwide analysis of childhood-onset systemic lupus erythematosus mortality in Mexico, 2000-2023

ObjectiveTo evaluate national and regional trends in age-standardized mortality rates (ASMRs) from childhood-onset systemic lupus erythematosus (cSLE) in Mexico between 2000 and 2023, stratified by sex and region.MethodsThis cross-sectional, retrospective study used the INEGI national death registry via the Public Health Intelligence Unit (UISP-INSP). Deaths in children aged 1-14 years attributed to cSLE were identified using ICD-10 codes M32.1, M32.8, and M32.9, excluding M32.0. ASMRs per 100,000 population were calculated using the 2010 Mexican census as a reference. Trends by year, sex, and region were analyzed using Poisson regression models with log link and population offset. Incidence rate ratios (IRRs) with 95% confidence intervals were estimated.ResultsFrom 2000 to 2023, 637 cSLE deaths were recorded among 280,334 child deaths. Females accounted for 80.4% (ASMR 0.13; 95% CI 0.12-0.15), nearly fourfold higher than males (0.03; 95% CI 0.03-0.04). Although the Central and Midwest regions concentrated over 60% of total deaths, ASMRs were similar across regions (range 0.08-0.09 per 100,000). No consistent temporal trend in mortality was observed. Poisson regression confirmed significantly lower mortality in boys compared to girls (IRR 0.24; 95% CI 0.19-0.29; p < 0.001) with no statistically significant regional differences.ConclusionscSLE mortality in Mexico has remained stable over time, with a marked female predominance. The regional distribution of deaths likely reflects population density rather than major differences in mortality risk. Strengthening early diagnosis, paediatric rheumatology care networks, and national surveillance systems is essential to reduce disease burden.