Am J Perinatol 2025; 42(10): 1304-1310
DOI: 10.1055/a-2489-4588
Original Article

Is Pregnancy a Risk Factor for Progression of Diabetic Retinopathy and Nephropathy in Type 1 Diabetes? A Matched Cohort Study

Francis Mimouni
1   Department of Pediatrics and Research Institute, Leumit Health Services, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Jane C. Khoury
2   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
3   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
4   Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Shelley Ehrlich
2   Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
3   Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
5   Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
,
Galit Sheffer-Mimouni
6   Department of Obstetrics and Gynecology, and Research Institute, Leumit Health Services, Tel Aviv, Israel
,
Barak Rosenn
7   Department of Obstetrics, Gynecology, and Reproductive Health, Rutgers New Jersey Medical School, Jersey city Medical Center, Newark, New Jersey
,
Menachem Miodovnik
8   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Inova Medical Campus, Falls Church, Virginia
› Author Affiliations
Funding The study was funded by the U.S. Department of Health and Human Services, National Institutes of Health (approval no.: HD 11725).
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Abstract

Objective

This study aimed to test the hypothesis that the development or deterioration of nephropathy and retinopathy over time is not affected by pregnancy in women with pregestational type 1 diabetes mellitus (T1DM).

Study design

Prospective, observational study of nephropathy and retinopathy follow-up during pregnancy and in a subsequent period of 2 years in a group of pregnant women with T1DM (study group) that we compared with pair-matched non-pregnant women with T1DM (control group) who underwent similar intensive follow-up.

Results

The rate of renal microvascular complications was similar at entry, 17.4% (4/23) in the study group and 21.7% (5/23) in the control group. At the last visit, both groups had nephropathy rates of 17.4% (4/23) and paired p-value of 1.00. Similarly, the rate of retinal microvascular complications of any grade was similar in both groups and remained so at the last follow-up examination.

Conclusion

Pregnancy per se does not appear to increase the risk for the development of, or the acceleration of the progression of retinopathy and nephropathy during a follow-up of at least 2 years in relatively healthy T1DM patients. This information is important for counseling young women with T1DM who are considering becoming pregnant.

Key Points

  • Retinopathy and nephropathy are major complications of T1DM.

  • Pregnancy per se does not appear to cause major microvascular complications in T1DM.

  • Pregnancy per se does not appear to aggravate retinopathy in T1DM.

Keywords

nephropathy - retinopathy - microvascular complications - type 1 diabetes mellitus


Publication History

Received: 30 May 2024

Accepted: 25 November 2024

Article published online:
24 December 2024

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