• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Meta-analysis: Pregnancy and Risk for Diabetic Retinopathy Progression

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Diabetic retinopathy (DR) may worsen during pregnancy among women with preexisting diabetes, but prevalence and risk of progression is unclear
  • Widyaputri et al. (JAMA Ophthalmology, 2022) estimate the prevalence of DR and its progression rate in pregnant women with preexisting type 1 (T1D) or type 2 diabetes (T2D) diagnosed before pregnancy

METHODS:

  • Systematic review and meta-analysis
  • Inclusion criteria
    • Observational studies
    • Studies that reported on DR and its changes in pregnant women with preexisting T1D and T2D
  • Study design
    • Data were pooled using a random-effects model
    • The study followed MOOSE reporting guidelines
  • Primary outcome
    • Prevalence of any DR
    • Proliferative DR
    • DR progression rates

RESULTS:

  • 18 studies | 1464 pregnant women with T1D; 262 with T2D
  • Pooled prevalence of DR in pregnancy
    • Any DR: 52.3 (95% CI, 41.9 to 62.6) per 100 pregnancies
    • Proliferative DR: 6.1 (95% CI, 3.1 to 9.8) per 100 pregnancies
  • Pooled progression rates
    • New DR development: 15.0 (95% CI, 9.9 to 20.8) per 100 pregnancies
    • Worsened nonproliferative DR: 31.0 (95% CI, 23.2 to 39.2) per 100 pregnancies
    • Progression from nonproliferative DR to proliferative DR: 37.0 (95% CI, 21.2 to 54.0) per 100 pregnancies
  • DR progression rates were similar between the T1D and T2D groups, except for the development of new DR
    • T1D groups: 15.8 (95% CI, 10.5 to 21.9) per 100 pregnancies
    • T2D groups: 9.0 (95% CI, 4.9 to 14.8) per 100 pregnancies
  • A global trend toward a lower DR progression rate was observed after the 1989 St. Vincent Declaration (Goals and standards for diabetes care developed by the European community under the auspices of WHO and International Diabetes Federation)

CONCLUSION:

  • Women with T1D and T2D face similar rates of DR progression during pregnancy and both groups should be monitored appropriately
  • However, rates of DR prevalence and progression remain higher in pregnant women with diabetes compared to nonpregnant women with diabetes
  • The authors conclude

Results of this systematic review and meta-analysis suggest that the risk of DR progression in pregnant women with preexisting DR was similar between women with T1D and T2D

Therefore, equal attention should be given to monitoring DR during pregnancy in those already known to have DR, irrespective of diabetes type

Learn More – Primary Sources:

Global Estimates of Diabetic Retinopathy Prevalence and Progression in Pregnant Women With Preexisting Diabetes: A Systematic Review and Meta-analysis

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Is Metformin Associated with Decreased Risk for Age-Related Macular Degeneration?
Type 1 and Type 2 Diabetes in Pregnancy: Adverse Events and Associated Risk Factors
Undiagnosed Type 2 Diabetes in Pregnancy vs GDM: What are the Perinatal Risks?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site