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Exposure to Type 1 and Type 2 Maternal Diabetes is Associated with Stage 3-5 Retinopathy of Prematurity

Adam Lewis1, Isaac Bakis2, Alexa Love3

  • 1Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.

Ophthalmology Science
|May 7, 2026
PubMed

Insights

Maternal diabetes, including type 1 and type 2, significantly increases the risk of vision-threatening retinopathy of prematurity (ROP) in infants. Early screening for ROP in infants exposed to maternal diabetes is crucial for preserving vision.

Area of Science:

  • Neonatal ophthalmology
  • Perinatal medicine
  • Endocrinology

Background:

  • Retinopathy of prematurity (ROP) and diabetic retinopathy share pathological similarities.
  • Maternal hyperglycemia in utero may increase infant ROP risk.
  • Previous studies on this association yielded conflicting results and did not differentiate DM subtypes.

Purpose of the Study:

  • To clarify the association between maternal diabetes mellitus (DM) and ROP progression.
  • To investigate the impact of maternal DM subtypes on infant ROP risk.
  • To adjust for significant comorbidities in the analysis.

Main Methods:

  • Retrospective cohort study of preterm infants (<31 weeks GA or <1500 g BW) from 2004-2021.
  • Data from Vanderbilt Neonatal Clinical Repository and chart review.
  • Multivariate logistic regression adjusted for GA, BW, sex, race, year, location, and comorbidities.

Main Results:

  • Stage 3-5 ROP was significantly associated with maternal DM (OR 3.04).
  • Both type 1 DM (T1DM) (OR 6.36) and type 2 DM (T2DM) (OR 5.82) were associated with increased ROP risk.
  • Lower birth weight and gestational age were linked to more severe ROP.

Conclusions:

  • Maternal diabetes (T1DM and T2DM) increases infant risk for vision-threatening ROP.
  • Infant BW and GA may not accurately reflect ROP progression risk in diabetic pregnancies.
  • Incorporate maternal DM status into ROP screening protocols to preserve infant vision.
Abstract

Keywords:
Bronchopulmonary dysplasiaIntraventricular hemorrhageMaternal diabetesNecrotizing enterocolitisRetinopathy of prematurity

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