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The use of insulin lispro by 12 pregnant women with diabetes did not cause the formation or progression of diabetic retinopathy. In fact, 14% of 42 pregnant women who used regular insulin either developed retinopathy or experienced a progression of the disease.

Fetuses with a ventral wall defect can be delivered vaginally unless there is another reason to perform a cesarean. This was the conclusion of a study of 102 fetuses with a prenatal diagnosis of ventral wall defect, which is an abdominal hernia.

Pregnancy may not cause women with insulin-dependent diabetes to have an increased risk or increased progression of kidney disease. Researchers studied 182 pregnant women with insulin-dependent diabetes mellitus (IDDM) whose pregnancies continued for at least 20 weeks and followed them up for at least three years. Neither pregnancy nor having many children were found to be risk factors for kidney disease. Significant risk factors for kidney disease were protein in the urine and poor blood sugar control during pregnancy. Women with kidney disease were more likely to have complications of pregnancy, including newborn complications. No significant predictors of kidney disease progressing to end-stage kidney disease were found.

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 [X.sup.2] 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. (Am J Obstet Gynecol 1992;166:1214-8.)

Diabetics tend to develop infection easily, and this is related to alterations in immune cell activity, especially in subjects with poorly controlled elevated glucose levels. Pregnancy is also associated with increased risk for infection, as immune system function is altered during that time. Thus, pregnant diabetic women are highly likely to develop infections. The risk of infection associated with diabetes was evaluated in 65 diabetic and 65 nondiabetic pregnant women, and the association of infection rate with poor glycemic control in diabetic patients was studied. Eighty-five percent of diabetic women developed infections during pregnancy, compared with an infection rate of only 26 percent in nondiabetic women. Postpartum rates of infection were also higher in diabetic women. Infection rates at all sites were elevated. No particular bacterial species was implicated, but diabetic women did tend to have more infections caused by a common fungus (or yeast), Candida. The results suggested that glycemic control may have been poorer preceding the development of infections in diabetic women. Further research is needed to determine if improved metabolic control will result in a lower risk of infection in diabetic pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)