Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 39 Jabotinsky St., 49100, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Graefes Arch Clin Exp Ophthalmol. 2023 Mar;261(3):803-808. doi: 10.1007/s00417-022-05829-w. Epub 2022 Sep 12.
To explore the effect of pregnancy on the clinical course, outcome, and treatment in multiparous women with non-infectious uveitis.
Retrospective study of women with a history of non-infectious uveitis and pregnancies prior to and during disease course. Disease activity and severity 1-year prior pregnancy, during pregnancy, and 1-year postpartum were recorded as well as patients' and diseases' characteristics. The main outcome measures included the rate and severity of uveitis attacks and the effect on ocular complications and therapies.
Included were 32 women (70 pregnancies, mean of 2.6 pregnancies/patient), with a mean follow-up time of 6.5 years. The most common uveitis types were anterior (31%) and pan-uveitis (31%). Flare-ups were more frequent in the year prior to pregnancy, in the first trimester, and in the postpartum period and decreased markedly during pregnancy. Women who experienced a flare-up during pregnancy had a higher rate of flare-ups in the year prior pregnancy than those who did not experience a flare-up during pregnancy (p-0.047). The rate of flare-ups 12 months' postpartum was also higher compared to women without any flare-up during pregnancy (p = 0.01). Severity of flare-ups in the postpartum period was worse in women who experienced a flare-up during pregnancy compared to women without flare-ups (p = 0.001). The severity of flare-ups was higher in the first pregnancy compared to subsequent pregnancies.
Women who had active or non-controlled uveitis prior to pregnancy have higher disease activity and severity during pregnancy as well. The first pregnancy seems to behave differently from subsequent pregnancies, in terms of disease severity.
探讨妊娠对既往有非感染性葡萄膜炎病史的多产妇的临床病程、结局和治疗的影响。
对既往有非感染性葡萄膜炎病史且在疾病病程中怀孕的女性进行回顾性研究。记录患者妊娠前 1 年、妊娠期间和产后 1 年的疾病活动度和严重程度，以及患者和疾病的特征。主要观察指标包括葡萄膜炎发作的发生率和严重程度，以及对眼部并发症和治疗的影响。
共纳入 32 名女性（70 次妊娠，平均每位患者 2.6 次妊娠），平均随访时间为 6.5 年。最常见的葡萄膜炎类型为前葡萄膜炎（31%）和全葡萄膜炎（31%）。在妊娠前 1 年、妊娠早期和产后期间，葡萄膜炎发作更为频繁，并在妊娠期间明显减少。在妊娠期间出现葡萄膜炎发作的女性，其在妊娠前 1 年的葡萄膜炎发作率高于未在妊娠期间出现葡萄膜炎发作的女性（p-0.047）。与无妊娠期间葡萄膜炎发作的女性相比，产后 12 个月的葡萄膜炎发作率也更高（p=0.01）。在妊娠期间出现葡萄膜炎发作的女性，其产后葡萄膜炎发作的严重程度高于无葡萄膜炎发作的女性（p=0.001）。与后续妊娠相比，首次妊娠的葡萄膜炎发作严重程度更高。
在妊娠前有活动期或未控制的葡萄膜炎的女性，在妊娠期间疾病活动度和严重程度更高。首次妊娠在疾病严重程度方面似乎与后续妊娠不同。
