Low uptake of screening for retinopathy during pregnancy with pre-existing diabetes: A population-based cohort study

Abstract

Aims

To determine the frequency of eye screening during pregnancy for people with pre-existing diabetes, and to examine what factors were associated with screening.

Methods

Using linked real-world population-level data in Ontario, Canada, we identified all livebirths to people with pre-existing diabetes between April 2015 and March 2020, and determined the proportion who had an eye screening examination during pregnancy. The associations between screening uptake and a variety of sociodemographic, clinical and health service variables were examined.

Results

Of 6,708 pregnancies among people with pre-existing diabetes, 1,256 (18.7 %) had an eye screening examination within the first trimester and 3,045 (45.4 %) had eye screening at any time during pregnancy. The highest eye screening rates were seen among those with prior retinopathy treatment, with longer diabetes duration, and on the insulin pump program. People who received care from an endocrinologist in the first 180 days of pregnancy were far more likely to have an eye examination.

Conclusions

Uptake of eye screening in the first trimester among people with pre-existing diabetes was extremely low, despite the risk of worsening and sight-threatening retinopathy during pregnancy. Even by the end of pregnancy, fewer than one-half of patients had received eye screening.