The course of non-infectious uveitis in pregnancy: a retrospective study of 79 pregnancies

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 261; no. 5; pp. 1391 - 1398
• Main Authors: Giorgiutti, S., Jamilloux, Y., Gerfaud-Valentin, M., Bert, A., Ballonzoli, L., Kodjikian, L., Korganow, AS, Poindron, V., Sève, P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2023; Springer Nature B.V
• Subjects: Diabetes mellitus; Female; France - epidemiology; Humans; Inflammatory Disorders; Medical records; Medicine; Medicine & Public Health; Obstetrics; Ophthalmology; Patients; Postpartum; Postpartum Period; Pregnancy; Pregnancy complications; Recurrence; Retrospective Studies; Uveitis; Uveitis - diagnosis; Uveitis - epidemiology; Uveitis - etiology; France; Pregnancy; Sarcoidosis; Relapses; Obstetric complications; Uveitis
• ISSN: 0721-832X; 1435-702X; 1435-702X
• DOI: 10.1007/s00417-022-05949-3

Purpose The study aims to describe the course and management of non-infectious uveitis during pregnancy and postpartum period in European populations. Methods A retrospective observational study in two tertiary centers in France was performed. Pregnant patients during the follow-up of a non-infectious uveitis as well as those with new-onset uveitis were included. The medical records were analyzed with a systematic collection of the characteristics of the uveitis, the treatment and evolution of the uveitis, and the course of the pregnancy including obstetric complications. Results Seventy-nine pregnancies in 59 women were included: 48 patients (68 pregnancies) were followed for uveitis and 11 had a new-onset uveitis diagnosis. Most patients had idiopathic uveitis (32.2%) or sarcoid uveitis (27.1%). Among the patients followed for uveitis at the time of conception, there were 18 relapses (26.5%) requiring treatment escalation. Relapses occurred mainly in the two first trimester ( n  = 12) or during the postpartum period ( n  = 5) and were significantly associated with an active uveitis at the time of conception (OR = 9.2, 95% CI [1.57–48.4], p  = 0.01). The characteristics of the new-onset uveitis were similar to those already existing before pregnancy. Obstetric complications occurred in 25 pregnancies (31.6%), mainly gestational hypertension and gestational diabetes. Conclusion The frequency of non-infectious uveitis relapses decreases as pregnancy progresses, in agreement with data from other non-European studies. However, multidisciplinary monitoring should be advised, especially to uncontrolled patients at the time of conception.