Progression of diabetic retinopathy in pregnancy: Association with hypertension in pregnancy1

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Objective: To test the hypothesis that women with insulin-dependent diabetes and chronic or pregnancy-induced hypertensive disorders are at increased risk for developing retinopathic complications during pregnancy.

Study design: One hundred fifty-four women with insulin-dependent diabetes were prospectively followed in an intensive program of diabetes in pregnancy. Ophthalmologic evaluations were obtained through pregnancy and at 6 to 12 weeks post partum, and findings were graded by a standard scale. Association of retinopathic progression with risk factors was tested with χ2 and multiple logistic regression analysis.

Results: Fifty-one women had progression of retinopathy during pregnancy; postpartum regression was observed in 13 women. Changes in glycemic control early in pregnancy, chronic hypertension, and pregnancy-induced hypertension were significantly associated with progression of retinopathy.

Conclusion: Women with insulin-dependent diabetes who have hypertensive disorders in pregnancy are at increased risk for progression of retinopathy.

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    1

    Supported in part by National Institutes of Health grant HD 11725, Diabetes in Pregnancy (Program Project Grant), United States Public Health Service Training in Perinatal Care and Research grant MCH MCT 000174, National Institutes of Health Clinical Research Center grant RR00068, and National Institutes of Health Perinatal Emphasis Research Center grant HD 10748.

    a

    From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Perinatal Research Institute, University of Cincinnati College of Medicine, and Children's Hospital Medical Center

    b

    Department of Ophthalmology,Perinatal Research Institute, University of Cincinnati College of Medicine, and Children's Hospital Medical Center

    c

    Department of Pediatrics, Perinatal Research Institute, University of Cincinnati College of Medicine, and Children's Hospital Medical Center.

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