title: Recurrence rates of ocular toxoplasmosis during pregnancy.
abstract: OBJECTIVE
  To investigate whether recurrence rates of ocular toxoplasmosis are higher during pregnancy in women of childbearing age.
  
  
  METHODS
  Retrospective longitudinal cohort study.
  
  
  METHODS
  We reviewed medical records of all women seen at a university eye clinic (Utrecht, Netherlands) during episodes of active toxoplasmic retinochoroiditis that occurred while the women were of childbearing age (16-42 years). Each woman was sent a questionnaire requesting information regarding all pregnancies and episodes of ocular toxoplasmosis, whether or not episodes were observed at the eye clinic. Conditional fixed-effects Poisson regression was used to model incidence rate ratios of recurrence during pregnant versus nonpregnant intervals, adjusted for potential confounders, including age at time of active toxoplasmic retinochoroiditis and interval since last episode of active disease, which are known to influence risk for recurrence.
  
  
  RESULTS
  Questionnaires were returned by 50 (58%) of 86 women, 34 of whom had had 69 pregnancies during 584 person-years of study. There were 128 episodes of ocular toxoplasmosis during the study period (6 during pregnancy). First episodes of ocular toxoplasmosis occurred between ages 9.6 and 38.5 years. The youngest age at pregnancy was 16.1 years; the oldest age at childbirth was 40.9 years. The incidence-rate ratios for pregnant versus nonpregnant intervals were in the direction of lower recurrence rates during pregnancy, with point estimates of 0.54 and 0.75 under 2 different approaches, but the ratios were not significantly different from the null value (P values of 0.16 and 0.55).
  
  
  CONCLUSIONS
  Recurrence rates of ocular toxoplasmosis are probably not higher during pregnancy, in contrast to traditional beliefs.
authors.affiliation: Department of Ophthalmology, VU Medical Center Amsterdam, the Netherlands.
authors.forename: Arthur M D
authors.initials: AM
authors.lastname: Braakenburg
authors.affiliation: Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, UCLA, Los Angeles, California.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
authors.affiliation: Ocular Inflammatory Disease Center, Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: uveitis@jsei.ucla.edu.
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.affiliation: Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, UCLA, Los Angeles, California.
authors.forename: Sheng
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, UCLA, Los Angeles, California; Ocular Inflammatory Disease Center, Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Aniki
authors.initials: A
authors.lastname: Rothova
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D002648:Child; D002825:Chorioretinitis / Q000175:diagnosis* / Q000453:epidemiology; D017050:Episode of Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014122:Toxoplasma / Q000276:immunology / Q000472:pathogenicity; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D007075:Immunoglobulin M