Seminars in ophthalmology · 2026
Maternal Diabetes Mellitus During Pregnancy as a Risk Factor for Congenital Nasolacrimal Duct Obstruction in the Offspring - a Large-Scale National Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Raz Amichai, Amitai Nir, Kerman Tomer, Eshkoli Tamar, Imtirat Ahed, Marciano Dor, Sheiner Eyal, Tsumi Erez
Аннотация
OBJECTIVE: To investigate whether maternal diabetes mellitus during pregnancy is a risk factor for CNLDO in offspring.
METHODS: This retrospective cohort study utilized electronic medical records from Clalit Health Services (CHS) in Israel, 2010-2023. Neonates were classified as born to diabetic or non-diabetic mothers. Mixed models assessed and compared demographic characteristics and ocular disorders between groups. Generalized estimating equations regression was applied to calculate odds ratios while adjusting for potential confounders.
RESULTS: 505,928 births were analyzed. CNLDO prevalence was 4.1% among children born to mother with diabetes, compared to 2.9% among children to non-diabetic mothers (OR-1.44, 95% confidence interval [CI] 1.35-1.54; p < .001). Among children to diabetic mothers receiving pharmacological treatment, CNLDO prevalence was 5.2%, while it was 3.7% when managed by diet (OR-1.44, 95% CI 1.26-1.64; p < .001). CNLDO prevalence was 4.7% in children to mothers with HbA1c levels greater than 6.5%, compared to 2.9% when HbA1c levels were below 6.5% (OR-1.62, 95% CI 1.30-2.03; p < .001). After adjusting for confounders, significant association was found between maternal diabetes during pregnancy and CNLDO prevalence in offspring (OR-1.47, 95% CI 1.37-1.58; p < .001).
CONCLUSIONS: Maternal diabetes during pregnancy independently increases CNLDO risk, especially in infants to mothers with more severe diabetes.
METHODS: This retrospective cohort study utilized electronic medical records from Clalit Health Services (CHS) in Israel, 2010-2023. Neonates were classified as born to diabetic or non-diabetic mothers. Mixed models assessed and compared demographic characteristics and ocular disorders between groups. Generalized estimating equations regression was applied to calculate odds ratios while adjusting for potential confounders.
RESULTS: 505,928 births were analyzed. CNLDO prevalence was 4.1% among children born to mother with diabetes, compared to 2.9% among children to non-diabetic mothers (OR-1.44, 95% confidence interval [CI] 1.35-1.54; p < .001). Among children to diabetic mothers receiving pharmacological treatment, CNLDO prevalence was 5.2%, while it was 3.7% when managed by diet (OR-1.44, 95% CI 1.26-1.64; p < .001). CNLDO prevalence was 4.7% in children to mothers with HbA1c levels greater than 6.5%, compared to 2.9% when HbA1c levels were below 6.5% (OR-1.62, 95% CI 1.30-2.03; p < .001). After adjusting for confounders, significant association was found between maternal diabetes during pregnancy and CNLDO prevalence in offspring (OR-1.47, 95% CI 1.37-1.58; p < .001).
CONCLUSIONS: Maternal diabetes during pregnancy independently increases CNLDO risk, especially in infants to mothers with more severe diabetes.