Ophthalmology Unit, HM Nens, Barcelona, Spain.
Institut Oftalmològic Eurolàser, Mataró, Barcelona, Spain.
Matern Child Health J. 2020 Apr;24(4):524-529. doi: 10.1007/s10995-020-02887-6.
Gestational diabetes (GD) occurs in 5.8% to 25.1% of pregnant women. This disorder has been linked with intrauterine growth delays, congenital anomalies, and neurobehavioral disorders following birth. As to ophthalmological effects, changes in macular thickness and hypoplasia of the upper quadrant of the papilla have been described.
To investigate whether GD has an effect on ophthalmological development in the children born of mothers with this condition.
Observational study carried out in children seen in the ophthalmological outpatient clinic of a pediatric hospital in Barcelona (Spain) between January 2011 and December 2015. Participants were ultimately divided into two groups, a study group whose mothers had GD managed either by insulin or diet (GD group) and a control group of children with non-diabetic mothers. Pregestational diabetes cases, were excluded. Complete information was collected on the children's refraction status, ophthalmological disease, and congenital malformations.
Data were compiled on 350 children (229 children born of mothers with GD-186 managed with diet vs 43, with insulin- and 121 controls). The prevalence of amblyopia and strabismus was similar between the groups, but children of mothers with GD had a three-fold greater probability of having refractive errors than children born to mothers without GD. Hyperopia (14.8% vs. 7.4%) and myopia (3.5% vs 0%) were found to be significantly more prevalent in children born of mothers with GD than in the controls (p = 0.027 in both groups).The prevalence of astigmatism was similar in both groups (1.7% vs 0.8%).
Refractive errors are more common in children born of mothers with GD. These conditions are easily managed, but if they are not detected, they can lead to amblyopia or accommodative strabismus, interfere with acquisition of fine motor skills, and lead to learning problems. Regular ocular examinations would be recommended in these patients.
妊娠糖尿病（GD）在 5.8%至 25.1%的孕妇中发生。这种疾病与宫内生长迟缓、先天性畸形和出生后神经行为障碍有关。至于眼科影响，已经描述了黄斑厚度的变化和视盘上象限的发育不良。
研究患有 GD 的母亲所生的儿童的眼科发育是否受到影响。
在西班牙巴塞罗那一家儿科医院的眼科门诊进行的观察性研究。参与者最终分为两组，一组为母亲患有 GD 且接受胰岛素或饮食治疗的研究组（GD 组），另一组为母亲无糖尿病的对照组。排除孕前糖尿病病例。收集了关于儿童屈光状态、眼科疾病和先天性畸形的完整信息。
共收集了 350 名儿童的数据（229 名母亲患有 GD 的儿童-186 名接受饮食治疗，43 名接受胰岛素治疗，121 名接受对照组）。两组间弱视和斜视的患病率相似，但母亲患有 GD 的儿童发生屈光不正的可能性是母亲无 GD 的儿童的三倍。母亲患有 GD 的儿童中，远视（14.8%对 7.4%）和近视（3.5%对 0%）的发生率明显高于对照组（两组均 p=0.027）。两组散光的患病率相似（1.7%对 0.8%）。
母亲患有 GD 的儿童更容易出现屈光不正。这些情况很容易治疗，但如果不被发现，可能会导致弱视或调节性斜视，干扰精细运动技能的获得，并导致学习问题。建议对这些患者进行定期眼部检查。
