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Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes

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 eval...

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Autores principales: Egan, Aoife M., McVicker, Lyle, Heerey, Adrienne, Carmody, Louise, Harney, Fiona, Dunne, Fidelma P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402566/
https://www.ncbi.nlm.nih.gov/pubmed/25945354
http://dx.doi.org/10.1155/2015/310239
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author Egan, Aoife M.
McVicker, Lyle
Heerey, Adrienne
Carmody, Louise
Harney, Fiona
Dunne, Fidelma P.
author_facet Egan, Aoife M.
McVicker, Lyle
Heerey, Adrienne
Carmody, Louise
Harney, Fiona
Dunne, Fidelma P.
author_sort Egan, Aoife M.
collection PubMed
description 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.
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spelling pubmed-44025662015-05-05 Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes Egan, Aoife M. McVicker, Lyle Heerey, Adrienne Carmody, Louise Harney, Fiona Dunne, Fidelma P. J Diabetes Res Research Article 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. Hindawi Publishing Corporation 2015 2015-04-06 /pmc/articles/PMC4402566/ /pubmed/25945354 http://dx.doi.org/10.1155/2015/310239 Text en Copyright © 2015 Aoife M. Egan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Egan, Aoife M.
McVicker, Lyle
Heerey, Adrienne
Carmody, Louise
Harney, Fiona
Dunne, Fidelma P.
Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title_full Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title_fullStr Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title_full_unstemmed Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title_short Diabetic Retinopathy in Pregnancy: A Population-Based Study of Women with Pregestational Diabetes
title_sort diabetic retinopathy in pregnancy: a population-based study of women with pregestational diabetes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402566/
https://www.ncbi.nlm.nih.gov/pubmed/25945354
http://dx.doi.org/10.1155/2015/310239
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