Gravidity and diabetic retinopathy.

The relationship between gravidity and severity of diabetic retinopathy was investigated in a population-based sample of diabetic patients. All of these women had had diabetes diagnosed before 30 years of age and were taking insulin. All received their primary medical care in an 11-county region of southwestern Wisconsin (Health Service Area 1). Each participant had an ophthalmologic examination which included stereoscopic fundus photography of seven standard fields in each eye. Photos were graded according to a standard protocol. Of the 397 women, 197 had never been pregnant, 88 had been pregnant once, 56 had been pregnant twice, and 56 had been pregnant three or more times after diabetes was diagnosed. The number of pregnancies was positively associated with the severity of retinopathy. However, after controlling for duration of diabetes, this relationship was no longer apparent. Using an ordinal regression model, duration of diabetes, diastolic blood pressure and glycosylated hemoglobin were significant predictors of the severity of diabetic retinopathy.