Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study,Diabetologia

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Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study
Diabetologia ( IF 8.2 ) Pub Date : 2021-08-17 , DOI: 10.1007/s00125-021-05526-z
Jiangbo Du _{1,

2,

3} , Jiong Li ₃ , Xiaoqin Liu ₄ , Hu Liu ₅ , Carsten Obel ₆ , Hongbing Shen _{1,

2} , Zhibin Hu _{1,

2} , Yongfu Yu _{7,

8,

9}

Affiliation

Aims/hypothesis

We aimed to investigate the associations between maternal diabetes before or during pregnancy and the risk of high refractive error (RE) in offspring until the age of 25 years.

Methods

This nationwide register-based cohort study comprised 2,470,580 individuals born in 1977–2016. The exposure was maternal diabetes during or before pregnancy (type 1 diabetes, type 2 diabetes and gestational diabetes). Cox regression was used to examine the association between maternal diabetes and the risk of high RE in offspring from birth until the age of 25 years, adjusting for multiple potential confounders.

Results

During up to 25 years of follow-up, 553 offspring of mothers with diabetes and 19,695 offspring of mothers without diabetes were diagnosed with high RE. Prenatal exposure to maternal diabetes was associated with a 39% increased risk of high RE: HR 1.39 (95% CI 1.28, 1.51), p < 0.001; standardised cumulative incidence in unexposed offspring at 25 years of age 1.18% (95% CI 1.16%, 1.19%); cumulative incidence difference 0.72% (95% CI 0.51%, 0.94%). The elevated risks were observed for hypermetropia (HR 1.37 [95% CI 1.24, 1.51], p < 0.001), myopia (HR 1.34 [95% CI 1.08, 1.66], p = 0.007) and astigmatism (HR 1.58 [95% CI 1.29, 1.92], p < 0.001). The increased risks were more pronounced among offspring of mothers with diabetic complications (HR 2.05 [95% CI 1.60, 2.64], p < 0.001), compared with those of mothers with diabetes but no diabetic complications (HR 1.18 [95% CI 1.02, 1.37], p = 0.030).

Conclusions/interpretation

Our findings suggest that maternal diabetes during pregnancy is associated with an increased risk of high RE in offspring, in particular among those of mothers with diabetic complications. Early ophthalmological screening should be recommended in offspring of mothers with diabetes diagnosed before or during pregnancy.

Graphical abstract

中文翻译：

妊娠期母体糖尿病与后代高屈光不正的关系：一项基于全国人群的队列研究

目标/假设

我们旨在调查妊娠前或妊娠期间母体糖尿病与后代高屈光不正 (RE) 风险之间的关联，直至 25 岁。

方法

这项基于全国登记的队列研究包括 2,470,580 名出生于 1977-2016 年的人。暴露是怀孕期间或怀孕前的母体糖尿病（1型糖尿病、2型糖尿病和妊娠糖尿病）。Cox 回归用于检查母体糖尿病与后代从出生到 25 岁的高 RE 风险之间的关联，并调整了多个潜在的混杂因素。

结果

在长达 25 年的随访中，553 名患有糖尿病的母亲的后代和 19,695 名没有糖尿病的母亲的后代被诊断出患有高 RE。产前暴露于母体糖尿病与高 RE 风险增加 39% 相关：HR 1.39（95% CI 1.28, 1.51），p < 0.001；25 岁未暴露后代的标准化累积发病率 1.18% (95% CI 1.16%, 1.19%)；累积发病率差异 0.72% (95% CI 0.51%, 0.94%)。远视（HR 1.37 [95% CI 1.24, 1.51], p < 0.001）、近视（HR 1.34 [95% CI 1.08, 1.66], p = 0.007）和散光（HR 1.58 [95% CI 1.29, 1.92], p < 0.001)。与患有糖尿病但没有糖尿病并发症的母亲（HR 1.18 [95% CI 1.02, 1.37]，p = 0.030）。