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Cited by 24Retinal Diseases and TreatmentsGestational Diabetes Research and ManagementRetinopathy of Prematurity Studies

Risk factors for the development or progression of diabetic retinopathy in pregnancy: Meta‐analysis and systematic review

Sarvepalli, Swara M., Bailey, Beth A., D'Alessio, David, Lemaitre, Madleen, Vambergue, Anne, Rathinavelu, Jay, Hadziahmetovic, Majda·2023·Clinical & Experimental Ophthalmology
DOI 10.1111/ceo.14168
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Abstract

BACKGROUND: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it increases in severity during pregnancy. METHODS: Systematic review of literature from PubMed, Cochrane Library and Web of Science using keywords 'diabetic retinopathy' and 'pregnancy' and 'progression' from inception to 2021 was completed. Included studies were (1) peer-reviewed observational studies addressing progression/development of DR in pregnancy, (2) provided the number of diabetic patients that developed/progressed in DR during pregnancy, and (3) included differential data on variables between progression and non-progression groups. This was applied by two independent researchers and referred to a third researcher as necessary. Twenty-seven of the original 138 studies met this criterion. Data were pooled and analysed using fixed-effects in meta-analysis. RESULTS: From 27 studies, 2537 patients were included. Pre-eclampsia [Risk Ratio (RR) 2.62 (95% CI = 1.72, 4.00)] and hypertension treatment during pregnancy [RR 2.74 (95% CI = 1.72, 4.00)] were significantly associated with the development/progression of DR. HbA1c at baseline [MD 0.82 (95% CI = 0.59, 1.06)], duration of diabetes [mean difference (MD) 5.97 (95% CI = 5.38, 6.57)], and diastolic blood pressure at baseline [MD 3.29 (95% CI = 0.46, 6.12)] were all significantly higher in the progression group while only mean birth weight [MD -0.17 (95% CI = -0.31, -0.03)] was significantly higher in the non-progression group. CONCLUSIONS: This study fills a gap in the literature and provide physicians with more information on the risk factors associated with the progression of DR in pregnancy and how to counsel this vulnerable patient population appropriately.

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  • Meta-analyses have demonstrated a high risk of new-onset retinopathy and progression of existing retinopathy in pregnant individuals with type 1 or type 2 diabetes.

    “Meta-analyses have also demonstrated a high risk of newonset retinopathy and progression of existing retinopathy in pregnant individuals with type 1 or type 2 diabetes (110,111).”

    From 15. Management of Diabetes in Pregnancy: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [110]

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Authors
Sarvepalli, S. M., Bailey, B. A., D'Alessio, D., Lemaitre, M., Vambergue, A., Rathinavelu, J., & Hadziahmetovic, M.
Affiliations
  • Central Michigan University (US)
  • Department of Endocrinology Duke University Durham North Carolina USA
  • Department of Endocrinology, Diabetology and Metabolism Lille University Hospital Lille France
  • Duke University (US)
Corresponding author
Hadziahmetovic, Majda
ORCID
Venue
Clinical & Experimental Ophthalmology
Publisher
Wiley
Published
2022-09-25
Volume
51
Issue
3
Pages
195-204
ISSN
  • 1442-6404 (ISSN-L)
  • 1442-9071
DOI
10.1111/ceo.14168
OpenAlex
W4295359252
Cited by
24
References
52
Citations by year
2026: 6 · 2025: 6 · 2024: 6 · 2023: 6
FWCI
0.97
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical and Experimental Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (acceptedVersion)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinopathy of Prematurity Studies
Keywords
diabetic retinopathy, pregnancy, retinopathy progression, risk factors, preeclampsia, antihypertensive therapy, HbA1c, diabetes duration, diastolic blood pressure, birth weight
MeSH terms
Blood Pressure, Diabetes Mellitus, Diabetic Retinopathy, Humans, Risk Factors

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