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Gestational diabetes mellitus is a significant risk factor for long-term ophthalmic morbidity

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased risk for long-term ophthalmic morbidity.

Methods

Design a population-based study compared the incidence of long-term maternal ophthalmic morbidity in a cohort of women with and without a history of GDM. Setting Soroka University Medical Center. Participants: All singleton pregnancies of women who delivered between 1988 and 2013. Main outcome measure(s) Diagnosis of ophthalmic morbidity. Analyses A Kaplan–Meier survival curve was used to estimate cumulative incidence of ophthalmic morbidity. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for ophthalmic morbidity.

Results

During the study period, 104,751 deliveries met the inclusion criteria; 9.4% (n = 9888) of which occurred in patients with a diagnosis of GDM during at least one of their pregnancies. Patients with GDM had a significantly higher incidence of ophthalmic morbidity such as glaucoma, diabetic retinopathy, and retinal detachment compared with controls (0.1 vs. 0.02%, p < 0.001; 0.2 vs. 0.04%, p < 0.001; 0.2 vs. 0.1%, p < 0.001, respectively). Patients with concurrent GDM and preeclampsia had a significantly higher incidence of total ophthalmic complications compared to patients with GDM only (1 vs. 0.6%, respectively, p < 0.001). Using Kaplan–Meier survival curve, patients with a previous diagnosis of GDM had significantly higher cumulative incidence of ophthalmic morbidity (p < 0.001, log-rank test). In the Cox proportional hazards model, a history of GDM remained independently associated with ophthalmic morbidity (adjusted HR 2.0; 95% CI 1.5–2.8; p < 0.001).

Conclusions

GDM is an independent risk factor for long-term maternal ophthalmic morbidity.

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Abbreviations

AAPP:

American academy of ophthalmology practice

CI:

Confidence Interval

DM:

Type 2 diabetes mellitus

GDM:

Gestational diabetes mellitus

HR:

Hazard ratio

ICD-9:

International Classification of Diseases, 9th revision

NICE:

National institute for health and care excellence

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Author contributions

OB: protocol/project development, data management, manuscript writing (original draft preparation), and editing. RS: data collection and management, Other: methodology and manuscript editing. RK: protocol/project development, data management, and manuscript editing. ISS: data management, manuscript writing, and editing. AW: data management and manuscript writing/editing. ES: protocol/project development and manuscript editing. ET: manuscript editing; Other: ophthalmic consultation. ES: project development and manuscript editing; other: methodology.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel

    Ofer Beharier, Roy Kessous, Asnat Walfisch & Eyal Sheiner

  2. Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Ruslan Sergienko

  3. Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Irit Szaingurten-Solodkin & Eden Shusterman

  4. Department of Ophthalmology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Erez Tsumi

Authors
  1. Ofer Beharier
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  2. Ruslan Sergienko
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  3. Roy Kessous
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Corresponding author

Correspondence to Ofer Beharier.

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Funding

This study was not supported by funds.

Conflict of interest

The authors declare that they have no conflict of interest. The authors are responsible for study design, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the article for publication.

Ethical approval

The Institutional Review Board approved the study. The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. For this type of study, formal consent is not required.

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This article does not contain any studies with animals performed by any of the authors.

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Beharier, O., Sergienko, R., Kessous, R. et al. Gestational diabetes mellitus is a significant risk factor for long-term ophthalmic morbidity. Arch Gynecol Obstet 295, 1477–1482 (2017). https://doi.org/10.1007/s00404-017-4362-4

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