Impact of Pregnancy on Progression of Diabetic Retinopathy

Abstract

Background: diabetic retinopathy is a microvascular complication of diabetes mellitus and remains an important cause of visual morbidity. Pregnancy is known to influence the course of diabetic retinopathy due to metabolic, hormonal, and hemodynamic changes.
Objective: To assess the impact of pregnancy on the progression of diabetic retinopathy and identify associated risk factors among pregnant women with diabetes.
Methods: From April 2025 to February 2026, 150 pregnant women with pregestational or gestational diabetes participated in a prospective observational research. First-trimester, second-trimester, third-trimester, and postpartum ophthalmic exams were conducted. The conventional fundus examination was used to grade the progression of retinopathy. Glycemic control and maternal clinical indicators were noted. SPSS version 24 was used for the statistical analysis, and p <0.05 was deemed significant.
Results: Progression of diabetic retinopathy was observed in 42 (28%) women. Progression was significantly higher in women with pregestational diabetes, longer duration of diabetes, poor glycemic control (HbA1c >7%), and baseline retinopathy. Severe progression requiring laser treatment occurred in 10 (6.7%) patients. Women with diabetes duration >5 years had significantly higher progression rates (p=0.002).
Conclusion: Diabetic retinopathy is known to significantly worsen during pregnancy, especially in women who already have diabetes and have poor metabolic control. During pregnancy, intensive interdisciplinary monitoring and early ocular screening are crucial.