Diabetic Retinopathy in Pregnant Women with Pre-gestational Diabetes: an Ambispective Study in the Eastern Part of India on Prevalence, Progression, Risk Factors, and Outcomes

Background: Pregnancy significantly exacerbates diabetic retinopathy (DR) progression in women with diabetes mellitus (DM). Despite extensive research showing this deterioration, data on DR risk and progression in women with pre-gestational DM in eastern India remains sparse. This study focuses on addressing this data gap, aiming to inform clinical practices and healthcare policies.Aim of The Study: To evaluate the prevalence and progression of DR in pregnant women with pre-gestational diabetes and analyze associated risk factors and pregnancy outcomes.Method: This ambispective study included pregnant women with diabetes. The retrospective component collected personal and medical histories, while the prospective component systematically collected data during each trimester and postpartum. DR progression was graded using the ETDRS classification.Of 44 patients, 6 (13.6%) were diagnosed with DR, with 5 cases of non-proliferative DR and 1 case of proliferative DR. The DR progression rate was 66.66%. Patients with DR had a significantly longer mean diabetes duration (10.5 years) compared to those without DR (4.84 years). Diastolic blood pressure was significantly associated with DR in the second and third trimesters. Among patients without DR, 63.1% had full-term deliveries, while 66.66% of those with DR had preterm deliveries.Conclusion: This research highlights the need for data on DR prevalence and progression in pregnant women with pre-gestational diabetes in eastern India. The study emphasizes the importance of diabetes duration and diastolic blood pressure in DR progression during pregnancy. Good glycemic control, timely interventions, comprehensive monitoring, and multidisciplinary care are crucial for improving maternal and neonatal outcomes.