title: Diabetic retinopathy in pregnancy: a population-based study of women with pregestational diabetes.
abstract: The aim of this observational study was to evaluate screening and progression of diabetic retinopathy during pregnancy in women with pregestational diabetes attending five antenatal centres along the Irish Atlantic seaboard. An adequate frequency of screening was defined as at least two retinal evaluations in separate trimesters. Progression was defined as at least one stage of deterioration of diabetic retinopathy and/or development of diabetic macular edema on at least one eye. Women with pregestational diabetes who delivered after 22 gestational weeks (n = 307) were included. In total, 185 (60.3%) had an adequate number of retinal examinations. Attendance at prepregnancy care was associated with receiving adequate screening (odds ratio 6.23; CI 3.39-11.46 (P < 0.001)). Among those who received adequate evaluations (n = 185), 48 (25.9%) had retinopathy progression. Increasing booking systolic blood pressure (OR 1.03, CI 1.01-1.06, P = 0.02) and greater drop in HbA1c between first and third trimesters of pregnancy (OR 2.05, CI 1.09-3.87, P = 0.03) significantly increased the odds of progression. A significant proportion of women continue to demonstrate retinopathy progression during pregnancy. This study highlights the role of prepregnancy care and the importance of close monitoring during pregnancy and identifies those patients at the highest risk for retinopathy progression.
authors.affiliation: Galway Diabetes Research Centre, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Aoife M
authors.initials: AM
authors.lastname: Egan
authors.affiliation: Galway Diabetes Research Centre, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Lyle
authors.initials: L
authors.lastname: McVicker
authors.affiliation: Galway Diabetes Research Centre, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Heerey
authors.affiliation: Galway Diabetes Research Centre, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Louise
authors.initials: L
authors.lastname: Carmody
authors.affiliation: Department of Ophthalmology, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Harney
authors.affiliation: Galway Diabetes Research Centre, National University of Ireland Galway and University Hospital Galway, Newcastle, Galway, Ireland.
authors.forename: Fidelma P
authors.initials: FP
authors.lastname: Dunne
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008269:Macular Edema / Q000503:physiopathology*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology*
chemical_list: D006442:Glycated Hemoglobin