June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Maternal diabetes, particularly Type 2 diabetes, is associated with increased odds of Stage 3-5 retinopathy of prematurity.
Author Affiliations & Notes
  • Dolly Ann Padovani-Claudio
    Ophthalmology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Alexa Love
    Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Adam Lewis
    Bioinformatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Lisa Bastarache
    Bioinformatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Jennifer Sucre
    Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
    Neonatology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Sara Van Driest
    Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
    Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Footnotes
    Commercial Relationships   Dolly Padovani-Claudio None; Alexa Love None; Adam Lewis None; Lisa Bastarache None; Jennifer Sucre None; Sara Van Driest None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4178 – F0238. doi:
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      Dolly Ann Padovani-Claudio, Alexa Love, Adam Lewis, Lisa Bastarache, Jennifer Sucre, Sara Van Driest; Maternal diabetes, particularly Type 2 diabetes, is associated with increased odds of Stage 3-5 retinopathy of prematurity.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4178 – F0238.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Retinopathy of prematurity (ROP) and diabetic retinopathy (DR) are leading causes of blindness. Retinal hypoxia, inflammation, and pre-retinal neovascularization characterize both conditions. Pregnancy, poor glycemic control, and diabetes mellitus (DM) duration are associated with worsening DR. On the other hand, low gestational age (GA), low birth weight (BW) and exposure to comorbidities like necrotizing enterocolitis (NEC) are risk factors for ROP progression. Pathologic similarities between ROP and DR posit that maternal DM (in-utero hyperglycemia) may increase a premature infant’s risk of retinopathy progression to vision-threatening stages (Stage 3-5). However, the few studies that address this question describe conflicting results and no studies have reported data on specific maternal DM sub-types. Our study further explores the contribution of maternal DM-type to this potential association.

Methods : This retrospective cohort study included infants born between January 2004 and December 2017 with GA between 22 weeks 0 days and 30 weeks 6 days or with BW <1500g, who had documented staging on ROP screening, and who survived to at least day-of-life 30 and to 40 weeks corrected GA. The study investigated the association between Stage 3-5 ROP and maternal DM using multivariate analysis including GA, BW, year of birth, and NEC. A two-sided t-Test with p<0.05 was used for statistical significance.

Results : 2386 of 17066 infants met inclusion criteria. Of these 2386 infants, 1612 (67.5%) had Stage 0 (no ROP controls) and 242 (10.1%) had Stage 3-5 ROP. Maternal DM was found in 131 infants (8.1%) with Stage 0 ROP and 17 infants (7%) with Stage 3-5 ROP. In the multivariate analysis, a positive association with OR of 2.2 (95% CI: 1.0-4.3, p=0.03) was detected between Stage 3-5 ROP and maternal DM. Sub-analysis by DM-type suggested a significant association between Stage 3-5 ROP and maternal Type 2 DM (OR 3.7, 95% CI 1.3-10.1, p=0.012), but not with Type 1 DM (OR 5.9, 95% CI: 0.7-33, p=0.06) or with gestational DM (OR 1.1, 95% CI 0.4-3.0, p=0.859).

Conclusions : Our results suggest that maternal diabetes, particularly Type 2 DM, may confer an increased risk of developing vision-threatening ROP. Incorporating this risk factor to screening decisions may be valuable to preserve vision in at-risk infants.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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