title: Obesity during pregnancy and long-term risk for ophthalmic morbidity - a population-based study with a follow-up of more than a decade.
abstract: OBJECTIVE
  To investigate whether patients with a history of obesity during pregnancy have an increased risk for subsequent long-term ophthalmic complications, after controlling for diabetes and preeclampsia.
  
  
  METHODS
  A population-based study compared the incidence of long-term maternal ophthalmic complications in a cohort of women with and without a history of obesity during pregnancy. Deliveries occurred between the years 1988 and 2013, with a mean follow-up duration of 12 years.
  
  
  RESULTS
  During the study period 106 220 deliveries met the inclusion criteria; 2.2% (n = 2353) occurred in patients with a diagnosis of obesity during at least one of their pregnancies. These patients had a significantly higher incidence of ophthalmic complications in total and specifically of diabetic retinopathy. Using a Kaplan-Meier survival curve, we found that patients with a history of obesity during pregnancy had a significantly higher cumulative incidence of ophthalmic complications. Using a Cox proportional hazards model, adjusted for confounders such as maternal age, preeclampsia and diabetes mellitus, we found obesity during pregnancy remained independently associated with ophthalmic complications (adjusted HR, 2.4; 95% CI, 1.4-4.2; p = 0.003).
  
  
  CONCLUSIONS
  Obesity during pregnancy is an independent risk factor for long-term ophthalmic complications, and specifically diabetic retinopathy.
authors.affiliation: a Department of Obstetrics and Gynecology , Faculty of Health Sciences, Soroka University Medical Center .|b Department of Physiology and Cell Biology , Faculty of Health Sciences .
authors.forename: Inbal
authors.initials: I
authors.lastname: Sasson
authors.affiliation: a Department of Obstetrics and Gynecology , Faculty of Health Sciences, Soroka University Medical Center .
authors.forename: Ofer
authors.initials: O
authors.lastname: Beharier
authors.affiliation: c Department of Epidemiology and Health Services Evaluation .
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: b Department of Physiology and Cell Biology , Faculty of Health Sciences .
authors.forename: Irit
authors.initials: I
authors.lastname: Szaingurten-Solodkin
authors.affiliation: a Department of Obstetrics and Gynecology , Faculty of Health Sciences, Soroka University Medical Center .
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
authors.affiliation: d Department of Ophthalmology , Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva , Israel.
authors.forename: Nadav J
authors.initials: NJ
authors.lastname: Belfair
authors.affiliation: a Department of Obstetrics and Gynecology , Faculty of Health Sciences, Soroka University Medical Center .
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003930:Diabetic Retinopathy / Q000209:etiology; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Cohort study; eye diseases; health consequences of obesity; maternal pregravid obesity; pregnancy