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Diabetic Mums Indicate Screening for Kids

The children of mothers with diabetes, diagnosed before or during pregnancy, should be regularly screened for refractive error (RE), according to findings from a Danish study of 2,470,580 individuals born in 1977–2016.

The nationwide study found a significant association between maternal diabetes before or during pregnancy and the risk of high RE among the study participants.

Over up to 25 years of follow-up, 553 offspring of mothers with diabetes (0.93 per 1,000 person-years) and 19,695 offspring of mothers without diabetes were diagnosed with RE (0.42 per 1,000 person-years).

The authors reported that 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%).

There were elevated risks 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).

Diabetic complications included diabetic coma, ketoacidosis, and diabetes with kidney, ophthalmic, neurological, circulatory, unspecified, or multiple complications.

The study reported that rates of diabetes had drastically increased over the past few decades, as only 0.4% of mothers in 1977 had some form of diabetes versus 6.5% in 2016. Additionally, mothers with diabetes were more likely to be older, well-educated, live alone, and have a higher parity (≥5 pregnancies of ≥20 weeks of gestation) versus mothers free of diabetes.


Du J, et al. Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide populationbased cohort study. Diabetologia 2021; DOI: 10.1007/s00125- 021-05526-z.