# Active Pediatric Systemic Lupus Erythematosus in Fars Province, Iran: Associations With Geographical and Meteorological Determinants—A Retrospective Cross‑Sectional Study

## TL;DR

This study found that urban living increases the risk of active pediatric lupus in Iran, while higher rainfall reduces it, using GIS to analyze environmental factors.

## Contribution

This is the first GIS-based study in Iran to investigate environmental influences on pediatric systemic lupus erythematosus.

## Key findings

- Urban setting is a significant risk factor for active pediatric SLE in Fars province.
- Higher annual rainfall is associated with a lower likelihood of active pediatric SLE.
- Other meteorological and environmental factors showed no significant association with active pediatric SLE.

## Abstract

Pediatric systemic lupus erythematosus (SLE) is a complex autoimmune disease influenced by genetic and environmental factors such as sunlight and temperature. This retrospective study investigated the association between meteorological and geographical factors and active pediatric SLE in Fars province, southwest Iran.

The residential addresses of pediatric patients with active SLE who were hospitalized at the main referral hospital of southwest Iran in Shiraz City between March 2016 and January 2023 were extracted from their medical records and geographically mapped. The influence of meteorological factors, such as temperature, humidity, evaporation, rainfall, as well as geographical parameters including land cover, slope, and altitude, on active pediatric SLE was evaluated using geographic information system (GIS) analysis. Data were analyzed using univariate and multivariate binary logistic regression analysis.

This study included 143 pediatric patients with active SLE from 34 out of a total of 8181 city/village areas. There was a significant positive association between urban setting and active pediatric SLE (OR = 75.949, CI = 9.521–605.846) while mean annual rainfall demonstrated a significant negative association (OR = 0.997, CI = 0.994–1.000) in the univariate analysis. Multivariate analysis revealed that urban setting was the only significant factor positively correlated with active pediatric SLE (OR = 56.567, CI = 6.731–745.372). There was no association between other meteorological and environmental factors and active pediatric SLE.

This study found that living in urban areas and lower annual rainfall are significant risk factors for active pediatric SLE in Fars province, probably due to increased exposure to pollutants and ultraviolet radiation. While previous studies have linked SLE activity to temperature and humidity, no such associations were observed here, highlighting the need for further research on regional environmental influences on SLE.

Urban environment as a risk factor: Living in urban areas significantly increases the risk of active pediatric systemic lupus erythematosus (SLE).Protective role of rainfall: Higher mean annual rainfall is associated with a lower likelihood of active pediatric SLE, possibly due to its effect on reducing pollution and UV exposure.First GIS‐based study in Iran: This study uniquely applies Geographic Information System (GIS) analysis to investigate environmental influences on pediatric SLE in Fars province.

Urban environment as a risk factor: Living in urban areas significantly increases the risk of active pediatric systemic lupus erythematosus (SLE).

Protective role of rainfall: Higher mean annual rainfall is associated with a lower likelihood of active pediatric SLE, possibly due to its effect on reducing pollution and UV exposure.

First GIS‐based study in Iran: This study uniquely applies Geographic Information System (GIS) analysis to investigate environmental influences on pediatric SLE in Fars province.