Pregnancy and Diabetic Retinopathy
In 1950 Beetham reported on the occurrence of retinopathy in a group of 200 pregnant diabetics. He found that diabetic retinopathy deteriorated during pregnancy, and his results were supported by data from further studies (Oakley 1953; Stephens et al. 1963). In 12 patients with proliferative retinopathy, Beetham observed that all experienced visual deterioration and four progressed to blindness. Later studies by White (1965) confirmed that both haemorrhagic and proliferative retinopathy worsened during pregnancy and that there was a tendency towards regression of the retinopathy (i.e. improvement) after delivery, an observation made anecdotally in two cases of longstanding diabetes by Lawrence in 1948. Beetham (1950) advocated that patients with proliferative retinopathy should avoid pregnancy, and terminations should be offered to pregnant diabetics on the basis that more than 50% of patients with any degree of retinopathy had a reduced chance of a successful pregnancy and all patients with proliferative retinopathy at the onset of pregnancy experienced perinatal mortality plus visual loss.
KeywordsGrowth Hormone Diabetic Retinopathy Proliferative Diabetic Retinopathy Proliferative Retinopathy Pregnant Diabetic
Unable to display preview. Download preview PDF.
- Ashton N (1983) Pathogenesis of diabetic retinopathy. In: Little HL, Jack RL, Patz A, Forsham PH (eds) Diabetic retinopathy. Thieme-Stratton, New York, pp 85–97Google Scholar
- Cohen MP, Jasti K, Rye DL (1977) Somatomedin in insulin dependent diabetes mellitus. J Clin Endocrinol Metab 60:648–657Google Scholar
- Kuniman MW, Welborn TA, McCann VJ, Stanton KG, Constable IJ (1986) Multiple factors in the prediction of risk of proliferative diabetic retinopathy. N Engl J Med 313:1433–1438Google Scholar
- McIntosh L, Muckersie L, Forrester JV (1988) Retinal capillary endothelial cells prefer different substrates for growth and migration. Tissue Cell 20 (in press)Google Scholar
- Michaelson IC (1948) The mode of development of retinal vessels. Trans Ophthalmol Soc UK 68:137–180Google Scholar
- Nash H (1979) Growth failure, somatomedin and growth hormone levels in juvenile diabetes mellitus: a pilot study. Aust NZ J Med 45:236–239Google Scholar
- Neilsen JH (1984) Direct effect of gonadal and contraceptive steroids on insulin release from mouse pancreatic islets in organ culture. Acta Endocrinol 105:245–250Google Scholar
- Serup L (1986) Influence of pregnancy on diabetic retinopathy. Acta Endocrinol (Suppl) 277:122–124Google Scholar
- Van Ohrt (1984) The influence of pregnancy on diabetic retinopathy with special regard to the reversible changes shown in 100 pregnancies. Acta Ophthalmol 62:603–616Google Scholar
- West KM (1978) Epidemiology of diabetes and its vascular lesions. Elsevier, New York p. 425Google Scholar