Purpose

To explore the effect of pregnancy on the clinical course, outcome and treatment in multiparous women with non-infectious uveitis.

Methods

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. Main outcome measures included rate and severity of uveitis attacks and effect on ocular complications and therapies.

Results

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=0.005). The rate of flare-ups postpartum was also higher compared to women without any flare-up during pregnancy (p=0.0001). 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.

Conclusions

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.