Progression of retinopathy in type 1 diabetic women during pregnancy.
Progression of diabetic retinopathy (DR) occurs at least temporarily during pregnancy and postpartum. The pathogenetic mechanisms of DR progression during pregnancy are not fully understood. Several factors related to metabolic changes (hyperglycaemia), diabetes itself (duration of diabetes before conception, baseline status of DR), pregnancy physiology (hypervolaemia and hypercoagulation, impaired retinal autoregulation) and pregnancy complications (pre-eclampsia) seem to play important roles in the progression of DR during pregnancy. On the other hand, systemic angiopoietic and vasoactive factors seem to have minor role in the deterioration of DR during that time period. Good glycaemic control, normotension, lack of nephropathy as well as lack of pre-proliferative/proliferative changes of DR are good prognostic factors as regards the progression of DR during pregnancy. However, pregnancy seems to have no long-term detrimental effects as regards the progression of DR unless it has proceeded to pre-proliferative and proliferative phases.
Kaaja
Risto
R
Department of Obstetrics and Gynecology, Helsinki University Hospital, Haartmaninkatu 2, 00290, Helsinki, Finland. risto.kaaja@hus.fi
Loukovaara
Sirpa
S
D042501:Angiogenic Proteins / Q000502:physiology; D002320:Cardiovascular Physiological Phenomena; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology; D003930:Diabetic Retinopathy / Q000209:etiology / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000473:pathology; D007328:Insulin / Q000009:adverse effects; D036341:Intercellular Signaling Peptides and Proteins / Q000502:physiology; D008954:Models, Biological; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D014883:Water-Electrolyte Imbalance / Q000150:complications
D042501:Angiogenic Proteins; D007328:Insulin; D036341:Intercellular Signaling Peptides and Proteins