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The course of uveitis in pregnancy and postpartum
  1. Nathalie P Y Chiam1,
  2. Anthony J H Hall2,3,
  3. Richard J Stawell3,4,
  4. Lucy Busija1,
  5. Lyndell L P Lim1,3,4,5
  1. 1Department of Ophthalmology, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
  2. 2Department of Ophthalmology, The Alfred Hospital, Melbourne, Australia
  3. 3Eye Surgery Associates, Melbourne, Victoria, Australia
  4. 4Ocular Immunology Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  5. 5Victoria Parade Eye Consultants, Melbourne, Victoria, Australia
  1. Correspondence to Dr Lyndell Lim, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC 3002, Australia; limllp{at}unimelb.edu.au

Abstract

Aim To examine the course of non-infectious uveitis during pregnancy.

Methods This is a retrospective case series. The medical records of 47 subjects with a previous history of non-infectious uveitis pre-dating their pregnancy were reviewed. Uveitis activity during the periods 1 year before pregnancy, during pregnancy and 1 year postpartum, were recorded. Information on patient demographics, type of uveitis, medication use, sex of child and breastfeeding status were also collected. The main outcome measures were the events of flare-ups during the prepregnancy, pregnancy and postpartum periods.

Results The rate of flare-up was 1.188 per person year prior to pregnancy, 0.540 per person year during pregnancy and 0.972 per person year in postpartum (p<0.001 for comparison between prepregnancy and pregnancy; p=0.009 for comparison between pregnancy and postpartum). Rates of flare-up only began to decrease in the second trimester. After delivery, rates of flare-up rebounded and within 6 months postpartum, flare-up rates were not significantly different from prepregnancy levels (p=0.306). Even so, 40% of subjects were found to have remained inactive within 1 year postpartum.

Conclusions Uveitis activity decreased by mid-pregnancy, but returned to prepregnancy levels within 6 months postpartum. These findings may be used to adjust uveitis management during pregnancy and the postpartum period.

  • Immunology
  • Inflammation

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