[Diabetic retinopathy during pregnancy].

Introduction: The aim was to evaluate the prevalence and progression of diabetic retinopathy during pregnancy in women with type 1 or type 2 diabetes.
Material and Methods: Dilated fundal photography was performed at approximately 10 and 28 gestational weeks in 58 and 18 women with type 1 and type 2 diabetes, respectively. Retinopathy was classified as five stages +/- macular oedema. Progression was defined as deterioration corresponding to at least one stage between the two examinations. Clinical parameters were obtained from the medical records.
Results: Diabetic retinopathy was found in 36 (62%) women with type 1 and three (17%) with type 2 diabetes at the first examination. In 26 (34%) retinopathy progressed; four women developed proliferations, three macular oedema and three reduction of visual acuity >/=0.2 on Snellen's chart in at least one eye. HbA1c in early pregnancy was the only significant predictor of progression (odds ratio = 1.75, 95% confidence interval = 1.09-2.82). Progression of retinopathy also tended to be associated with type 1 diabetes and long diabetes duration.
Conclusion: The risk of progression of diabetic retinopathy during pregnancy was considerable, especially among women with high HbA1c values in early pregnancy. A few women developed proliferations, macular oedema and reduction of visual acuity. Development of sight-threatening alterations during pregnancy remains a clinical problem.