Pregnant women with diabetes face increased risks of diabetic retinopathy. Our eye doctors provide expert care to monitor and safeguard your vision throughout pregnancy.
Pregnant women with preexisting diabetes face unique challenges when it comes to diabetic retinopathy (DR), a condition where high blood sugar levels damage the retina’s blood vessels. This piece explores why pregnancy can influence DR’s prevalence and progression, offering insight into the risks and reasons careful eye care is essential during this critical time. Our eye doctors are here to help you understand these risks and guide you in regular monitoring to protect your vision.
Diabetic retinopathy is an eye condition caused by prolonged high blood sugar levels that damage the small blood vessels in the retina. In pregnant women with preexisting type 1 or type 2 diabetes, hormonal shifts and circulatory changes can intensify this damage, increasing both the prevalence and progression of DR compared to nonpregnant individuals with diabetes. Studies have shown that more than half of pregnant women with diabetes may show signs of DR early on, a statistic that underscores the importance of regular retinal examinations during pregnancy.
During pregnancy, the body undergoes significant physiologic adjustments, including increases in circulating blood volume, changes in vascular resistance, and hormonal fluctuations. These factors can affect the integrity of the delicate retinal blood vessels. In a diabetic state, where the retinal vasculature is already compromised, such changes can further destabilize the blood-retinal barrier and lead to worsening or new onset of DR.
Recent systematic reviews and meta-analyses have provided robust data on the prevalence of DR among pregnant women with preexisting diabetes. In early pregnancy (before 22 weeks’ gestation), the pooled prevalence of any DR is reported to be around 52.3% per 100 pregnancies. Proliferative DR, the more advanced and sight-threatening form, has a prevalence of approximately 6.1% at this stage. As pregnancy progresses towards delivery, these numbers can increase, with any DR reaching about 57.8% and proliferative DR rising to around 8.2% per 100 pregnancies.
These figures indicate that more than half of pregnant women with diabetes may already have some degree of retinal damage early in pregnancy. This elevated prevalence compared to nonpregnant diabetic populations — which are estimated to have an overall DR prevalence of roughly 34.6% — highlights the necessity for early eye examinations and continuous monitoring during pregnancy.
Contact us today to schedule your comprehensive eye examination and protect your vision during this critical time.
One of the most critical concerns for pregnant women with diabetes is not just the presence of DR but its potential to worsen over the course of pregnancy. The progression rate of DR during pregnancy varies widely. For instance, studies have estimated that per 100 pregnancies, the development of new DR in women who initially had no DR is around 15.0. For those with already detectable nonproliferative DR (NPDR), about 31.0 per 100 pregnancies could experience a worsening by at least one severity level.
Even more concerning, the progression from NPDR to the proliferative form (PDR) is noted at around 6.3 per 100 pregnancies, while worsening of existing PDR occurs in approximately 37.0 per 100 pregnancies. Interestingly, while the development of new DR is higher in women with type 1 diabetes compared to type 2, the overall risk of progression in those already with DR seems similar regardless of diabetes type.
These progression rates underscore that a significant proportion of pregnant women who already have DR are at risk for more severe retinal damage. Even if early DR seems mild or non-sight threatening, the risk of progression — particularly to forms that could lead to vision loss — remains a pressing concern. Understanding these risks allows both patients and our eye doctors to emphasize the importance of close follow-up examinations throughout pregnancy and the postpartum period.
Pregnancy initiates a cascade of physiological and hormonal changes that can exacerbate diabetic retinopathy. Here’s the thing: several mechanisms are likely at play, making the retinal environment more sensitive to fluctuations in blood sugar and blood flow.
These mechanisms work together, creating a perfect storm that can accelerate DR progression during pregnancy. Even if a patient begins pregnancy with mild DR, without regular monitoring and management, there is a substantial risk that the damage could worsen, leading to sight-threatening complications.
Contact us today to schedule your comprehensive eye examination and protect your vision during this critical time.
Understand the risks of diabetic retinopathy during pregnancy and why regular eye care is crucial for maintaining vision health.
