title: Do pregnancy, postpartum period and lactation predispose to recurrent toxoplasmic retinochoroiditis?
abstract: BACKGROUND
  The aim of the study was a statistical analysis of the possible effects of pregnancy, postpartum period, and lactation on increased risk for reactivation of toxoplasmic retinochoroiditis.
  
  
  METHODS
  A retrospective study was undertaken of the clinical records of 661 patients referred with the diagnosis of acute toxoplasmic retinochoroiditis to the Department of Zoonoses and Tropical Diseases, Medical University of Warsaw and to the Department of Ophthalmology, Medical University of Warsaw in the years 1994-2014. This group of inpatients consisted of 213 women of child-bearing age (18 to 40 years). Reactivation of toxoplasmic retinochoroiditis was observed in 24 women aged 15 to 39 years who were pregnant, in the postpartum period, or lactating. To compare the rate of the relapses in pregnant/lactating patients vs. non-pregnant/non-lactating patients, the Fisher exact test was used. Calculations were performed with WinPepi software (Abramson JH (2004) WINPEPI (PEPI-for-Windows) for epidemiologists. Epidemiologic Perspectives & Innovations, 2005, 1: 6).
  
  
  RESULTS
  A total of 28 reactivations of toxoplasmic retinochoroiditis were observed (16 episodes in pregnancy, 4 in the postpartum period, and 8 during lactation) in 24 women aged 15 to 39 years. In 3 women, multiple episodes were reported (in early pregnancy and the postpartum period in 2 women, and during 2 pregnancies and lactation in 1 woman). Statistical analysis showed that the risk of an episode of toxoplasmic retinochoroiditis is 7.4-fold higher in pregnancy compared to the non-pregnant/non-lactating women (p<0.0001).
  
  
  CONCLUSIONS
  Women of childbearing age with toxoplasma ocular lesions should be informed by their doctors about possible active recurrences during pregnancy and should be followed carefully by an ophthalmologist when pregnant.
authors.affiliation: Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Brydak-Godowska
authors.affiliation: Department of Zoonoses and Tropical Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Piotr Karol
authors.initials: PK
authors.lastname: Borkowski
authors.affiliation: Department-Centre for Monitoring and Analyses of Population Health Status, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rabczenko
authors.affiliation: Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Moneta-Wielgoś
authors.affiliation: Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kęcik
mesh_terms: D000293:Adolescent; D000328:Adult; D002833:Choroiditis / Q000150:complications / Q000453:epidemiology*; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D015994:Incidence; D007774:Lactation; D011044:Poland / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D012008:Recurrence; D012164:Retinal Diseases / Q000150:complications / Q000453:epidemiology*; D014126:Toxoplasmosis, Ocular / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult