Glaucoma management in pregnancy, how safe glaucoma medication are?

Abstract

AbstractPurpose: does the use of glaucoma medication during pregnancy can affect the outcome of pregnancy.Methods: Multicenter descriptive survey, for female patients age 18–45, who got pregnant while suffer from glaucoma. Charts reviewed for diagnosis, glaucoma severity, and race. Survey questions; they were asked for each pregnancy happened while they suffered from glaucoma about, pregnancy age, medications used, and patient‐reported pregnancy outcomes and complications. Main Outcome Measures: were patient‐reported and included pregnancy result; childbirth, miscarriage, stillbirth, therapeutic abortion (TAB)], method of delivery, occurrence of preterm labor, and other patient‐reported complications.Results: 114 pregnancies of 56 patients (mean 2.0 pregnancies per patient) were included. Three pregnancies with ended with TAB were excluded from further analysis. Mean age during pregnancy was 29.1 ± 5.7 years. Of the 111 pregnancies, 20 (18.0%) used no medications, 28 used one medication (25.2%), 38 used two (34.2%), 20 used three (18.0%), and 5 used four (4.5%). Medications used were topical carbonic anhydrase inhibitors (CAIs; n = 45), beta‐blockers (BB; n = 55), alpha‐agonists (AA; n = 56), and prostaglandin analogues (PGA; n = 28). Outcome rates in the overall cohort were: pre‐term contractions/labor in 6.3%, miscarriage (pregnancy loss ≤20 weeks) in 4.5%, stillbirth (pregnancy loss >20 weeks) in 4.5%, induction of labor for vaginal delivery in 11.9%, emergency caesarean delivery in 13.9%, neonatal intensive care unit (NICU) stay in 15.8%, congenital anomalies in 8.1%, and low birth weight in 10.9%. Fisher exact test was performed to assess associations of complications with individual agents, use of any agent, and different number of agents. AA use was associated with NICU stay, with a rate of 25.5% in the AA group, and most of the AA use NICU stays occurred in pregnancies with third trimester AA use. All other associations were not statistically significant.Conclusions: This survey suggests an overall favourable safety profile for topical glaucoma medications in pregnancy. So, glaucoma medications can be used during pregnancy, but caution should be employed regarding third trimester AA use owing to an association with NICU stay.