Premium
Impact of pregnancy on the progression of diabetic retinopathy in Type 1 diabetes
Author(s) -
Temple R. C.,
Aldridge V. A.,
Sampson M. J.,
Greenwood R. H.,
Heyburn P. J.,
Glenn A.
Publication year - 2001
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2001.00535.x
Subject(s) - medicine , retinopathy , pregnancy , diabetic retinopathy , diabetes mellitus , type 1 diabetes , type 2 diabetes , endocrinology , genetics , biology
Aims To evaluate the impact of pregnancy on the progression of diabetic retinopathy in women with Type 1 diabetes mellitus and to identify risk factors for the progression of retinopathy during pregnancy. Methods One hundred and seventy‐nine pregnancies in 139 women with pregestational Type 1 diabetes were studied prospectively between January 1990 and December 1998. Dilated fundal examination was performed at booking, 24 weeks and 34 weeks or 4–6 weekly if retinopathy present at booking. Data were collected on glycaemic control (HbA 1c ) throughout pregnancy. Results Progression to proliferative retinopathy was seen in four (2.2%) pregnancies while moderate progression was seen in a further five (2.8%) pregnancies. Progression of retinopathy was significantly increased in women with duration of diabetes 10–19 years compared with duration < 10 years (10% vs. 0%; P = 0.007) and in women with moderate to severe background retinopathy at booking (30% vs. 3.7%; P = 0.01). Although HbA 1c at booking was higher (7.5% vs. 6.6%; P = 0.08) and the fall in HbA 1c between booking and 24 weeks was greater (1.6% vs. 1.2%; P = 0.2) in those women showing progression of retinopathy, these changes were not significant. Conclusions Progression of retinopathy in pregnancy was uncommon (5.0% pregnancies) but was significantly more common in women with duration of diabetes > 10 years and in women with moderate to severe retinopathy at baseline. Laser therapy was needed in 2.2% pregnancies, which is much lower than that reported in earlier studies. Diabet. Med. 18, 573–577 (2001)