Prolonged levels of increased serum urate in the blood (hyperuricemia) is the strongest risk factor for the development of gout; however, only up to 20% of individuals with hyperuricemia develop gout. Therefore, other pathogenic factors should be considered.
The modulation of the immune system during the perinatal and adolescent periods has been suggested as a risk factor for other inflammatory joint diseases and noninflammatory diseases such as ankylosing spondylitis, hypertension, hyperlipidemia, cardiovascular disease, and type 2 diabetes. Additionally, previous studies have reported an association between low birth weight and end-stage renal disease, which results in hyperuricemia and an increased risk of gout.
“We performed an exploratory analysis in the present study to investigate if, and to what extent, a broad range of maternal and perinatal factors, including birth weight, are associated with future risk of being diagnosed with gout,” researchers from the University of Gothenburg wrote of their study, which was published in Arthritis Research & Therapy.
Using a population-based retrospective nested case-control study protocol based on regional and national health care registers, researchers examined all incident cases of gout in individuals born in 1973 and onward who had received a diagnosis of gout from 2000 through 2019. The gout cohort was age- and sex- matched with a cohort of non-gout controls. Maternal, gestational, and perinatal factors were subsequently analyzed for a potential association with future gout development.
The gout and non-gout cohorts comprised 1,399 and 5,515 individuals, respectively. Univariate analysis showed that maternal diabetes was significantly related to the gout development, while maternal age, stature, and marital status had no association with gout. In addition, body mass index >30 at the beginning of pregnancy and maternal smoking were associated with gout.
Utilizing a multivariate analysis, researchers confirmed that maternal diabetes, congenital malformation, and small for gestational age were both significantly and independently associated with an increased the risk for future gout development.
Researchers suggested that maternal diabetes and small size relating to gestational age are perinatal factors that increase the risk for future gout development in young adults. “Since these factors are increasing in occurrence, they may contribute to the ongoing gout epidemic and thus require both confirmation and further delineation of underlying mechanisms,” they concluded.