Progression of diabetic retinopathy in pregnancy: association with hypertension in pregnancy.
OBJECTIVE
To test the hypothesis that women with insulin-dependent diabetes and chronic or pregnancy-induced hypertensive disorders are at increased risk for developing retinopathic complications during pregnancy.


METHODS
One hundred fifty-four women with insulin-dependent diabetes were prospectively followed in an intensive program of diabetes in pregnancy. Ophthalmologic evaluations were obtained through pregnancy and at 6 to 12 weeks post partum, and findings were graded by a standard scale. Association of retinopathic progression with risk factors was tested with chi 2 and multiple logistic regression analysis.


RESULTS
Fifty-one women had progression of retinopathy during pregnancy; postpartum regression was observed in 13 women. Changes in glycemic control early in pregnancy, chronic hypertension, and pregnancy-induced hypertension were significantly associated with progression of retinopathy.


CONCLUSIONS
Women with insulin-dependent diabetes who have hypertensive disorders in pregnancy are at increased risk for progression of retinopathy.
Rosenn
B
B
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, OH 45267-0526.
Miodovnik
M
M
Kranias
G
G
Khoury
J
J
Combs
C A
CA
Mimouni
F
F
Siddiqi
T A
TA
Lipman
M J
MJ
D003922:Diabetes Mellitus, Type 1; D016640:Diabetes, Gestational; D003930:Diabetic Retinopathy / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011254:Pregnancy in Diabetics; D011446:Prospective Studies; D012044:Regression Analysis