Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis – PLoS Blogs
Retinopathy.
In pregnant women with preexisting diabetic retinopathy, The hazard of illness development or onset was significantly elevated for nulliparous women (OR 1.75, 95% CI 1.28 to 2.40, p < 0.01, I2 = 0%; 4 research) [18,54–56] and people who smoke (OR 2.31, 95% CI 1.25 to 4.27, p = 0.01, I2 = 0%; 5 research) [54,57–60] (Desk 2). Pregnant women with progressive diabetic retinopathy had a imply 4.51 further years since diabetes evaluation (weighted imply distinction 4.51 y, 95% CI…….
Retinopathy.
In pregnant women with preexisting diabetic retinopathy, The hazard of illness development or onset was significantly elevated for nulliparous women (OR 1.75, 95% CI 1.28 to 2.40, p < 0.01, I2 = 0%; 4 research) [18,54–56] and people who smoke (OR 2.31, 95% CI 1.25 to 4.27, p = 0.01, I2 = 0%; 5 research) [54,57–60] (Desk 2). Pregnant women with progressive diabetic retinopathy had a imply 4.51 further years since diabetes evaluation (weighted imply distinction 4.51 y, 95% CI 2.26 To six.76 y; p < 0.01, I2 = 78.9%, 7 research) than women with out progressive retinopathy [55,61–66]. There have been no variations in age (WMD −0.22 years, 95% CI −0.86 to 0.42, p = 0.50, I2 = 0.0%, 7 research) [55,56,60,62,63,65,66] or BMI (WMD 0.06 kg/m2, 95% CI −1.05 to 1.16, p = 0.92, I2 = 1.2%, 4 research) [56,60,63,66] between women with and with out new or progressive retinopathy. Following exclusion of papers with extreme hazard of bias, The hazard of progressive retinopathy was Not vital for people who smoke (OR 1.13, 95% CI 0.17 to 7.59, p = 0.90, I2 = 63%, 2 research) [54,59]. The estimates from all completely different sensitivity analyses have been comparable (Desk C in S6 Appendix).
We found a greater hazard of illness development in pregnant women with retinopathy (OR 2.64, 95% CI 1.47 to 4.75, p <0.01, I2 = 79.7%; 15 research) [54–56,60–71], and nephropathy (OR 1.68, 95% CI 1.05 to 2.69, p = 0.03, I2 = 0.0%, 4 research) [54–56,71], On the time of The primary antenatal session As in contrast with these with out the diagnoses. No research reported development to blindness. Presence of baseline background or preproliferative retinopathy (OR 1.94, 95% CI 0.69 To 5.42, p = 0.21, I2 = 0%; 4 research) was not found to have an effect on retinopathy development) [54,62,67,72]. Pregnant women with preexisting proliferative retinopathy (OR 2.12, 95% CI 1.11 to 4.04, p = 0.02, I2 = 12.1%; 7 research) [55,62,67,69–72], have a 2.1-fold greater hazard of development As in contrast with women with lesser (no or background/preproliferative, respectively) modifications at baseline. Proliferative retinopathy was not primarytained as a hazard problem after excluding research with extreme hazard of bias (OR 1.44, 95% CI 0.64 To three.24, p = 0.38, I2 = 0%, 2 research) [55,71] or when collectively with women with type 1 diabetes solely (OR 2.04, 95% CI 0.89 to 4.67, p = 0.09, I2 = 41.5%, 6 research) [55,62,67,69–71]. The identical was true for any retinopathy when research at extreme hazard of bias have been excluded (OR 2.00, 95% CI 0.85 to 4.71, p = 0.11, I2 = 82.9%, 6 research) [54–56,64,68,71]. Following eradicating of research at extreme hazard of bias, earlier photocoagulation was found to be defending of deteriorating retinopathy (OR 0.23, 95% CI 0.06 to 0.99, p = 0.049, 1 research) [56]. Estimates from all completely different sensitivity analyses have been comparable (Desk C in S6 Appendix).
Source: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003856
