Prevalence of diabetic retinopathy in women with pregestational diabetes during pregnancy and the postpartum.

Autor: Widyaputri F; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.; Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia., Rogers SL; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia., Khong EWC; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia., Nankervis AJ; Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Diabetes and Endocrine Service, Royal Women's Hospital, Melbourne, Victoria, Australia., Conn JJ; Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Diabetes and Endocrine Service, Royal Women's Hospital, Melbourne, Victoria, Australia., Sasongko MB; Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia., Shub A; Perinatal Department, Mercy Hospital for Women, Heidelberg, Victoria, Australia.; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia., Fagan XJ; Department of Ophthalmology, Austin Hospital, Heidelberg, Victoria, Australia.; Medical Retina Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia., Guest D; Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia., Symons RCA; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.; Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia.; Department of Surgery, Alfred Hospital, Monash University, Clayton, Victoria, Australia., Lim LL; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.; Medical Retina Unit, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Jazyk: angličtina
Zdroj: Clinical & experimental ophthalmology [Clin Exp Ophthalmol] 2022 Sep; Vol. 50 (7), pp. 757-767. Date of Electronic Publication: 2022 Jun 07.
DOI: 10.1111/ceo.14111
Abstrakt: Background: Diabetic retinopathy (DR) may be affected by pregnancy. The majority of prevalence data regarding DR in pregnancy predate the advent of contemporary guidelines for diabetes management during pregnancy. This study reports DR prevalence and associated risk factors in women with pregestational diabetes during pregnancy and the postpartum in Australia.
Methods: A total of 172 pregnant women with type 1 (T1DM) or type 2 diabetes diagnosed pre-pregnancy were prospectively recruited from two obstetrics hospitals in Melbourne (November 2017-March 2020). Eye examinations were scheduled in each trimester, at 3-, 6-, and 12-months postpartum. DR severity was graded from two-field fundus photographs by an independent grader utilising the Airlie House Classification. Sight-threatening DR (STDR) was defined as the presence of diabetic macular oedema or proliferative DR.
Results: Overall, 146 (84.9%) women had at least one eye examination during pregnancy. The mean age was 33.8 years (range 19-51), median diabetes duration was 7.0 years (IQR 3.0-17.0), 71 women (48.6%) had T1DM. DR and STDR prevalence during pregnancy per 100 eyes was 24.3 (95% CI 19.7-29.6) and 9.0 (95% CI 6.1-12.9); while prevalence in the postpartum was 22.2 (95% CI 16.5-29.3) and 10.0 (95% CI 5.4-17.9), respectively. T1DM, longer diabetes duration, higher HbA1c in early pregnancy, and pre-existing nephropathy were significant risk factors.
Conclusions: The prevalence of DR in pregnant women was similar to the non-pregnant diabetic population in Australia. One in nine participants had STDR during pregnancy and the postpartum, highlighting the need to optimise DR management guidelines in pregnancy given the significant risk of vision loss.
(© 2022 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.)
Databáze: MEDLINE
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