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

Background and Aims: 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. Method: 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. Results: 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. Conclusion: 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.