Behçet's disease and pregnancy.
BACKGROUND
Behçet's disease (BD) is a multisystem inflammatory chronic disorder, which is characterized by relapsing oral and genital ulceration and iridocyclitis. While being of unknown etiology, vasculitic changes of possible autoimmune origin are common to all involved organs, and thrombotic complications, which may adversely affect gestation, are frequently seen. Very little is known to date about the reciprocal influence of BD and pregnancy. We have undertaken to explore the mutual effect of BD and pregnancy with emphasis on maternal and fetal complications.


METHODS
In this case-control study, we have evaluated pregnancies that occurred in women suffering from BD, who were treated in our institution during the last 25 years. All records were reviewed, and data were confirmed by a telephone interview and compared with a matched control group. To review the current knowledge, a Medline search together with a manual search of selected articles was performed.


RESULTS
Thirty-one Behçet's patients who had 135 pregnancies were studied. Remissions were significantly more frequent during both pregnancy and postpartum periods, while exacerbations were observed only in one-sixth of the patients (P < 0.001). Pregnancy complications (P < 0.001), cesarean section (P < 0.001), and miscarriage (P < 0.02) rates, however, were significantly higher in the study group.


CONCLUSIONS
Our study suggests that pregnancy does not have a deleterious effect on the course of BD and may possibly ameliorate its course. However, it seems that BD may adversely affect pregnancy. The miscarriage rate was higher, and the pregnancy complications and cesarean section rates were significantly elevated.
Jadaon
Jim
J
Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Ein-kerem, Jerusalem, Israel.
Shushan
Asher
A
Ezra
Yossef
Y
Sela
Hen Y
HY
Ozcan
Cuneyt
C
Rojansky
Nathan
N
D000022:Abortion, Spontaneous; D000328:Adult; D001528:Behcet Syndrome / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology