Acta Obstet Gynecol Scand 1998; 77: 814–818 Copyright C Acta Obstet Gynecol Scand 1998 Printed in Denmark – all rights reserved Acta Obstetricia et Gynecologica Scandinavica ISSN 0001-6349 ORIGINAL ARTICLE Pregnancies complicated by diabetic proliferative retinopathy FINN FRIIS LAUSZUS, POUL LANGE GRØN AND JOACHIM G. KLEBE From the Gynecological and Obstetrical Unit, Dept.Y, Skejby Hospital, Aarhus, Denmark Acta Obstet Gynecol Scand 1998; 77: 814–818. C Acta Obstet Gynecol Scand 1998 Background. To examine retinal and pregnancy outcome in insulin-dependent diabetic women with proliferative retinopathy and assess the effect of albuminuria on morbidity. Methods. The records of 26 women with known proliferative retinopathy before pregnancy were studied retrospectively in the prepregnancyperiod, during pregnancy, and after delivery. Perinatal and maternal morbidity was studied using ophthalmic, obstetric and pediatric rec- ords. Results. Seven pregnancies were delivered preterm (27%). Serious neonatal morbidity oc- curred in five pregnancies (19%). Perinatal survival was 88%. Laser treatment was given prior to pregnancy to 54%, during pregnancy to 27% and after delivery to 31% of the women. Laser treatment during pregnancy was more common in those with no prior photocoagulation and in White class F/R. Low birthweight was more frequently associated with nephropathy and proliferative retinopathy compared to retinopathy alone (p∞0.05). Recent hemorrhage, macul- opathy or glaucoma was found in 14 (54%) of the women. Blindness developed unilaterally in two women. Conclusions. Perinatal morbidity was associated with nephropathy rather than retinopathy. The incidence of hemorrhage, maculopathy or glaucoma was similar in White classes R and F/R. Key words: insulin-dependent diabetes mellitus; nephropathy; ocular morbidity; perinatal morbidity; proliferative retinopathy Submitted 17 March, 1998 Accepted 14 May, 1998 Proliferative retinopathy is an independent risk progressive nephropathy and glycemic malregul- ation (9–12). Once the diabetic woman has reached factor for the fetus and may lead to preterm deliv- ery in order to save eyesight (1, 2). Nephropathy is the stage of proliferative retinopathy, the incidence of further progression is unknown (13–16). This often concurrent and may also influence the out- come of pregnancy negatively. Reports on peri- study examined retinal and pregnancy outcome in pregnant diabetic women with known proliferative natal and maternal morbidity have emphasized the adverse role of nephropathy (3–5). Whether preg- retinopathy. nancy increases the risk of loss of sight is debated (6–8). Progression of retinopathy has been associ- Material and methods ated with initial adaption to pregnancy with rapid normalization of blood glucose and HbA 1c con- Forty-five pregnancies complicated by proliferative retinopathy among 507 insulin-dependent diabetic centrations and, during the second trimester, with pregnant women were recorded in Aarhus during 14 years between 1983 and 1996. Of these pregnan- Abbreviations: cies 26 had proliferation prior to pregnancy. Nine RDS: respiratory distress syndrome; IUGR: intrauterine growth retardation. women had more than one pregnancy. They were C Acta Obstet Gynecol Scand 77 (1998)