Abstract
Purpose :
Preeclampsia, a life-threatening hypertensive disease of pregnancy, induces systemic inflammation and is associated with autoimmune diseases. In recent practice, we noticed that some postpartum females with the history of preeclampsia had diagnosed of uveitis without positive findings for autoimmune diseases or ocular infection. Hence, this study aims to analyze the incidence and risks of noninfectious uveitis among postpartum females with preeclampsia in Taiwan.
Methods :
Data was collected from the Longitudinal Health Insurance Database 2005 (LHID 2005) of Taiwan. Postpartum females with preeclampsia were matched with the randomly selected ones without preeclampsia by age, gender, urbanization and income at a ratio of 1:4 from Jan. 1997 to Dec. 2013. All individuals were traced from the index date to the diagnosis of uveitis or censored if not diagnosed of uveitis within 5 years. Patients with a diagnosis of uveitis before the index date or uveitis-associated infection were excluded. The published covariates of uveitis (autoimmune diseases, thyroid diseases and diabetes mellitus) were added to adjust the outcome.
Results :
During the 17-year follow-up, 11 cases of noninfectious uveitis were identified in 1856 postpartum females with preeclampsia (0.6%) and 12 cases of that were identified in the 7424 comparison cases (0.2%) (P=0.001). Among 11 preclampsia females with noninfectious uveitis, the mean age of diagnosing preeclampsia was 29.6 years and the mean interval from the diagnosis of preeclampsia to the development of noninfectious uveitis was 1.68 years. In addition, 8 in 11 (73%) preclampsia females with uveitis were anterior uveitis and that showed significant difference compared to the non-preeclampsia group (P=0.005). The incidence rate of noninfectious uveitis per 1000 person-years was 1.3 and 0.4 for postpartum females with and without preeclampsia respectively (IRR= 3.68, 95% CI, 1.62-8.34; P=0.002). The risk of developing noninfectious uveitis was significantly higher in the preeclampsia group (Adjusted HR [95 % CI]: 4.07 [1.79-9.22]; P=0.001) after adjusting for the age, gender, income, urbanized level and covariates.
Conclusions :
Preeclampsia is an independent risk factor for the development of noninfectious uveitis among postpartum females. The underlying mechanisms between preeclampsia and non-infectious uveitis remain to be investigated.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.