Ophthalmic Changes in the Offspring of Pregnant Women with Gestational Diabetes Mellitus or Diabetes Mellitus - A Systematic Review.

Background: Gestational diabetes mellitus (GDM) affects 5.8% to 25.1% of pregnant women and is associated with a range of adverse perinatal outcomes, including intrauterine growth restriction, prematurity, neonatal respiratory distress, and adiposity. Offspring of mothers with GDM or diabetes mellitus (DM) are also at elevated risk for long-term metabolic complications, such as obesity, dyslipidemia, and type 2 DM. While systemic and structural anomalies-including congenital heart disease, skeletal malformations, and renal agenesis-have been well documented, limited attention has been paid to ophthalmic consequences. Accordingly, this study aims to summarize current evidence on the impact of maternal GDM/DM on the ocular development and long-term visual outcomes in offspring.

Methods: A review was conducted, integrating findings from studies describing ocular abnormalities in offspring born to mothers with GDM/DM.

Results: GDM/DM during pregnancy may contribute to a spectrum of ocular anomalies in offspring, including hypoplasia of the iris stroma, vascular tortuosity and dilation of the iris vessels, optic nerve hypoplasia, decreased macular thickness and volume, and an increased risk of long-term ophthalmic morbidity such as refractive errors.

Conclusion: Given the range of potential ophthalmic abnormalities in offspring of mothers with GDM/DM, regular ocular screening and long-term follow-up are recommended. Further research is warranted to better understand the underlying mechanisms and to develop evidence-based screening protocols.