Diabetic retinopathy in pregnancy during tight metabolic control.
BACKGROUND
The relation between retinopathy and the parameters: 24-h blood pressure, glucose control, albuminuria, and outcome of pregnancy was studied before, during, and after pregnancy in women with insulin-dependent diabetes mellitus on tight metabolic control during pregnancy.


METHODS
Prospective study of 112 pregnant women with insulin-dependent diabetes mellitus followed with fundus photography at the Department of Ophthalmology, Arhus University Hospital. Changes in retinopathy were related to 24-h blood pressure, blood glucose, albuminuria, and adverse perinatal outcome.


RESULTS
There was an association between grade of retinopathy and HbAlc before (Spearman's rho=0.49, p<0.04) and after pregnancy (Spearman's rho=0.42, p<0.02), but no such correlation was found at any examination during pregnancy where glycemia was kept tight. Those women who had progression of retinopathy during or after pregnancy had significantly earlier onset of diabetes mellitus (14+/-8 years, range 1-27) than those women with improvement or no progression of retinopathy (19+/-8 years, range 1-36, p<0.04). No association was found between progression of retinopathy and HbA1c, blood pressure, adverse perinatal outcome or any of the other variables studied.


CONCLUSIONS
Tight glycemic control during pregnancy is recommendable to avoid progression of retinopathy. Attention should be given to the period after delivery where the tight regulation may be difficult to achieve. IDDM women should be encouraged to plan pregnancies early in life.
Lauszus
F
F
Department of Gynecology and Obstetrics, Skejby Hospital, Denmark.
Klebe
J G
JG
Bek
T
T
D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000517:prevention & control*; D005260:Female; D005451:Fluorescein Angiography; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014792:Visual Acuity
D001786:Blood Glucose; D006442:Glycated Hemoglobin