Maternal diabetes mellitus as an independent risk factor for clinically significant retinopathy of prematurity severity in neonates less than 1500g

Opara, Chibuzor Nonye; Akintorin, Mopelola; Byrd, Allison; Cirignani, Natascha; Akintorin, Similolu; Soyemi, Kenneth

doi:10.1371/journal.pone.0236639

Cited by 16 publications

(15 citation statements)

References 32 publications

(49 reference statements)

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“…Despite the above data, maternal diabetes was associated with an increased rate of ROP in some studies. Opara et al showed among neonates weighing < 1500 g that the risk of ROP associated with maternal diabetes was 2.64 ( p < 0.01) [ 191 ]. They assumed that there are common pathogenic mechanisms in ROP and diabetic retinopathy as both are retinal vascular diseases in which there is leakage and/or neovascularization from damaged retinal vessels [ 191 ].…”

Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

“…Opara et al showed among neonates weighing < 1500 g that the risk of ROP associated with maternal diabetes was 2.64 ( p < 0.01) [ 191 ]. They assumed that there are common pathogenic mechanisms in ROP and diabetic retinopathy as both are retinal vascular diseases in which there is leakage and/or neovascularization from damaged retinal vessels [ 191 ]. Tunay et al also showed that maternal diabetes increased the incidence of ROP among premature infants > 1500 g and found a 25-fold and 6-fold increase in the risk of ROP and Type 1 ROP regardless of maternal diabetes type [ 192 ].…”

Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

“…Well-treated diabetes in pregnancy had a shoulder dystocia rate similar to controls. Hitaka et al [189] Grandi et al [190] Opara et al [191] Tunay et al [192] Diabetes in pregnancy increases the prematurity rate. The association between maternal diabetes and morbidities associated with prematurity vary between studies: no association [142,167], respiratory distress syndrome [189], necrotizing enterocolitis [158,190], late-onset sepsis [158], retinopathy of prematurity [158,191,192].…”

Section: Shoulder Dystociamentioning

confidence: 99%

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Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Ornoy

Becker

Weinstein-Fudim³

et al. 2021

IJMS

156

101

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In spite of the huge progress in the treatment of diabetes mellitus, we are still in the situation that both pregestational (PGDM) and gestational diabetes (GDM) impose an additional risk to the embryo, fetus, and course of pregnancy. PGDM may increase the rate of congenital malformations, especially cardiac, nervous system, musculoskeletal system, and limbs. PGDM may interfere with fetal growth, often causing macrosomia, but in the presence of severe maternal complications, especially nephropathy, it may inhibit fetal growth. PGDM may also induce a variety of perinatal complications such as stillbirth and perinatal death, cardiomyopathy, respiratory morbidity, and perinatal asphyxia. GDM that generally develops in the second half of pregnancy induces similar but generally less severe complications. Their severity is higher with earlier onset of GDM and inversely correlated with the degree of glycemic control. Early initiation of GDM might even cause some increase in the rate of congenital malformations. Both PGDM and GDM may cause various motor and behavioral neurodevelopmental problems, including an increased incidence of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most complications are reduced in incidence and severity with the improvement in diabetic control. Mechanisms of diabetic-induced damage in pregnancy are related to maternal and fetal hyperglycemia, enhanced oxidative stress, epigenetic changes, and other, less defined, pathogenic mechanisms.

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Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

Section: The Effects Of Diabetes In Pregnancy On the Newborn Infanmentioning

confidence: 99%

Section: Shoulder Dystociamentioning

confidence: 99%

See 1 more Smart Citation

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Ornoy

Becker

Weinstein-Fudim³

et al. 2021

IJMS

156

101

View full text Add to dashboard Cite

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“…Consequently, many centres use digital retinal photography as part of this screening process[ 65 ]. Opara et al [ 67 ] found that maternal diabetes was associated with a higher incidence of ROP. The strength of association increased with the increasing severity of ROP in preterm neonates less than 1500 mg.…”

Section: Postnatal Evaluationmentioning

confidence: 99%

Cardiac changes in infants of diabetic mothers

Al‐Biltagi

Razaky

Amrousy

2021

WJD

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Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. It affects all ages from the foetal life, neonates, childhood to late adulthood. Gestational diabetes is a critical risk factor for congenital heart diseases (CHDs). Moreover, the risk increases with low maternal education, high body mass index at conception, undiagnosed pre-gestational diabetes, inadequate antenatal care, improper diabetes control, and maternal smoking during pregnancy. Maternal DM significantly affects the foetal heart and foetal–placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs). Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography. Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography, detection of early atherosclerotic changes by measuring aortic intima-media thickness, and retinal vascular changes by retinal photography. Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention. However, other measures to reduce the risk, such as using medications, nutritional supplements, or probiotics, still need more research. This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM, the various cardiac outcomes of gestational DM on the foetus and offspring, cardiac evaluation of foetuses and IDMs, and how to alleviate the consequences of gestational DM on the offspring.

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“…Based on the pathogenesis, ROP and diabetic retinopathy are both retinal vascular diseases, in which there is leakage and/or neovascularization from damaged retinal vessels, based on retinal ischemia. Moreover, Opara et al [40] have suggested that maternal diabetes is associated with ROP, with the strength of association increasing with increasing severity of ROP. Ling et al [16] , however, reported that gestational diabetes did not correlate with ROP recurrences after IVR treatments.…”

Section: Discussionmentioning

confidence: 99%

Recurrence risk factors of intravitreal ranibizumab monotherapy in retinopathy of prematurity: a retrospective study at one center

Wu¹,

Zhao²,

Pu³

et al. 2023

Int J Ophthalmol

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AIM: To identify risk factors of recurrence of this disorder after intravitreal ranibizumab (IVR) monotherapy. METHODS: Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity (ROP) at our center were retrospectively reviewed between April 1, 2016 and December 31, 2017. Patient demographics, the side of ROP, multiple gestations, Apgar scores, zone, stage, plus disease, postmenstrual age at injection, surfactant therapy, blood transfusion therapy, hemorrhage before IVR, hemorrhage after IVR, gestational diabetes mellitus, pregnancy-induced hypertension, anemia, intraventricular hemorrhage, sepsis, respiratory distress syndrome, carbohemia, and congenital heart defects were recorded. Adjusted hazard ratios (HRs) and 95% confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression. RESULTS: Of the 33 eyes, 12 (36.4%) had ROP recurrences 45.3 (5.1, 50.9)mo after initial IVR treatments. The independent risk factors for ROP recurrences were zone (¢ò vs ¢ñ, HR: 0.056, P=0.003) and gestational diabetes mellitus (no vs yes, HR: 0.095, P<0.001). The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR (0.13, 0.70) at 55.0 (51.0, 58.9) mo after the initial IVR treatment. The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR (0.19, 0.63) at 48.0 (43.8, 58.4) mo after the initial IVR treatment. CONCLUSION: Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zone¢ñand gestational diabetes mellitus are identified, and the mean uncorrected visual acuity is 0.46 logMAR at 51.0 (44.0, 58.9)mo. The findings of this study are important for follow-up management and for improving the visual function of ROP patients.

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Maternal diabetes mellitus as an independent risk factor for clinically significant retinopathy of prematurity severity in neonates less than 1500g

Cited by 16 publications

References 32 publications

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Diabetes during Pregnancy: A Maternal Disease Complicating the Course of Pregnancy with Long-Term Deleterious Effects on the Offspring. A Clinical Review

Cardiac changes in infants of diabetic mothers

Recurrence risk factors of intravitreal ranibizumab monotherapy in retinopathy of prematurity: a retrospective study at one center

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