PREECLAMPSIA IS A POTENT RISK FACTOR FOR DETERIORATION OF RETINOPATHYDURING PREGNANCY IN TYPE-1 DIABETIC-PATIENTS

The aim of the present study was to examine the influence of pregnancy on deterioration of retinopathy in patients with Type 1 diabetes mell itus. Sixty-five pregnant Type 1 diabetic women attending the Universi ty Hospital in Lund were studied retrospectively. The degree of retino pathy, and levels of HbA(1c) and blood pressure 12 months before, duri ng, and 6 months after pregnancy were compared of those of 56 non-preg nant Type 1 diabetic women matched for age and duration of diabetes. F or all patients, sight-threatening deterioration of retinopathy did no t differ between the pregnancy group (9/65) and the control group (6/5 6). Over time, pregnant patients had lower HbA,, levels than controls (p<0.001). Pregnant patients with sight-threatening deterioration of r etinopathy had higher HbA(1c) levels than those without (p=0.028 and t he decrement in HbA,, between the 6-14th and the 20th week of gestatio n was more pronounced (p = 0.006). In those patients who developed pre -eclampsia during pregnancy, deterioration of retinopathy ocurred more frequently compared to those without pre-eclampsia (4/8 vs 5/65; p=0. 005). In conclusion, sight-threatening deterioration of retinopathy wa s not more common during pregnancy in IDDM patients than among age-and duration-matched control patients. In pregnant patients, deterioratio n of retinopathy was associated with the pregestational degree of meta bolic control as well as with a rapidly improved glycaemic control ach eived during pregnancy. Among those in whom deterioration occurred dur ing pregnancy, pre-eclampsia was a potent risk factor. (C) 1997 by Joh n Wiley & Sons, Ltd.