Abstract / Summary
Objectives: Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus and may worsen during pregnancy due to metabolic and hemodynamic changes. This study aimed to determine the prevalence of DR and identify its predictors among pregnant women with pregestational diabetes mellitus (PGDM).Materials and Methods: This retrospective cross-sectional study was conducted at a tertiary perinatal center between January and December 2024 and included 63 pregnant women with PGDM who underwent routine ophthalmologic examination during antenatal follow-up. Diabetic retinopathy was classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. Clinical and laboratory characteristics were compared between women with and without DR. Ridge-regularized logistic regression analysis was performed to identify independent predictors of DR.Results: The median maternal age was 32 years, and the mean body mass index was 29.4 ± 5.8 kg/m². Diabetic retinopathy was detected in 11 women (17.5%). Women with DR had a significantly longer duration of diabetes (median 10 vs. 5 years, p = 0.003) and higher HbA1c levels (7.9% vs. 6.8%, p = 0.02) than those without DR. Hypertension and nephropathy were more frequent among women with DR, although these differences did not reach statistical significance. In ridge-regularized logistic regression analysis, longer diabetes duration (adjusted OR = 2.9, 95% CI: 1.4–5.8) and higher HbA1c levels (adjusted OR = 1.8, 95% CI: 1.1–3.0) were independently associated with the presence of DR. The model demonstrated acceptable discriminatory performance (AUC = 0.78).Conclusion: Diabetic retinopathy was present in 17.5% of pregnant women with PGDM. Longer diabetes duration and poorer glycemic control were independently associated with the presence of DR. These findings support the importance of preconception metabolic optimization and regular ophthalmologic assessment during pregnancy, particularly in women with longstanding diabetes and suboptimal glycemic control.