Diabetic retinopathy during pregnancy.
OBJECTIVE
The purpose of the study is to evaluate the incidence, prevalence, progression, and risk factors of diabetic retinopathy during pregnancy.


METHODS
Sixty-five patients who were pregnant and had insulin-dependent diabetes mellitus were evaluated before pregnancy, in every trimester during the pregnancy, and 12 months postpartum. The medical data included age, diabetes duration, glycohemoglobin, fructosamine, hemoglobin, creatinine, uric acid, and systolic and diastolic blood pressure.


RESULTS
Progression of the retinopathy occurred in 77.5% of the patients who presented with diabetic retinopathy at conception; proliferative diabetic retinopathy occurred in 22.5%. Only 26% of the patients who started the pregnancy without diabetic retinopathy had some progression of the retinopathy. Duration of the diabetes was longer in the progressive group compared with the nonprogressive group (P = 0.007). The glycohemoglobin was higher in the progressive group than in the nonprogressive group at each time point, but only in the third trimester was the difference statistically significant (P = 0.04). The hemoglobin level was lower in the progressive group than in the nonprogressive group (P < 0.01). The systolic blood pressure was higher in the progressive group (P < 0.005).


CONCLUSIONS
Understanding the risk factors contributing to the aggravation of diabetic retinopathy during pregnancy is helpful in designing criteria for the team management of pregnant patients with diabetes.
Axer-Siegel
R
R
Department of Ophthalmology, Rabin Medical Center, Petah Tiqva, Israel.
Hod
M
M
Fink-Cohen
S
S
Kramer
M
M
Weinberger
D
D
Schindel
B
B
Yassur
Y
Y
D000328:Adult; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors