妊娠中および妊娠後の視力を脅かす糖尿病性網膜症 - 全国共通コホート研究
Janni E Larsson1, Lonny Stokholm2,3, Toke Bek4
1Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark.
Diabetes care
|August 26, 2025
まとめ
1型糖尿病の妊婦は,妊娠していない人と比較して,視力を脅かす糖尿病性網膜症 (DR) の治療を必要とするリスクが類似しています. この研究では,妊娠中または妊娠後に増殖性DRを発症するリスクは認められませんでした.
科学分野:
- 眼科について
- 内分泌学
- 生殖医学
背景:
- 糖尿病性網膜症 (DR) は盲目の主要な原因です.
- 妊娠はDRを含む糖尿病の合併症の進行に影響を与える可能性があります.
- 妊娠中および妊娠後の視力を脅かすDRのリスクは,慎重に評価する必要があります.
研究 の 目的:
- 1型糖尿病の妊婦の視力を脅かす糖尿病性網膜症 (DR) 治療のリスクを,妊婦でない対照群と比較する.
- 妊娠中および妊娠後の糖尿病性マキュラ腫 (DME) に対するパン網膜光凝固および抗VEGF注射の発生率を評価する.
主な方法:
- デンマークの国家登録を用いたマッチングコホート研究 (2013-2022年)
- 妊娠中の女性1,041人,妊娠していない女性1,041人.
- 妊娠前の36ヶ月から妊娠後の36ヶ月までのデータを分析した.
主要な成果:
- 妊婦と非妊婦のDR治療の比率は有意な差異はありません.
- 妊娠中の女性では増殖性DRへの進行率が高くなかった (aHR 0. 64 [95% CI 0. 32, 1.31]).
- 糖尿病性黄斑腫の治療は2つのコホートにおいて稀であった.
結論:
- 1型糖尿病の妊婦は,治療を必要とする視力を脅かすDRのリスクが高くありません.
- 視力を脅かすDRの発症リスクは,妊娠している女性と,妊娠していない女性とマッチした1型糖尿病の女性では同様です.
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