Rates of diabetic retinopathy screening in pregnant patients with type 1 and type 2 diabetes in a predominantly Indigenous Central Australian population

Abstract

Pregnancy is a risk factor for the progression of diabetic retinopathy (DR) in women with pre-gestational diabetes. Australian screening guidelines recommend DR screening in the first trimester of pregnancy. The rates of DR screening in pregnant patients with pre-gestational diabetes are unknown in Australia. To determine the rates of DR screening in pregnant women with pre-gestational diabetes at Alice Springs Hospital Diabetes Antenatal Care and Education (DANCE) clinic. Retrospective review of women with pre-gestational diabetes who attended the DANCE clinic between July 2016 and June 2020. There were 146 pregnancies in 144 individual women included in this review. There were 93% (n=134) who identified as Aboriginal but not Torres Strait Islander. DR screening was performed in 23 (16%) pregnancies, in which DR was present in six (26%) and no retinal abnormality was found in 17 (74%). Of seven (5%) women who had a history of DR, only three had a screen during the pregnancy period. The location of the DR screen included Alice Springs Hospital (17%, n=4), Alice Springs general practice clinics (35%, n=8) and remote NT community clinics outside of Alice Springs (39%, n=9). The trimesters in which women received their DR screens were: trimester 1, 45%, n=10; trimester 2, 39%, n=9; trimester 3, 17%, n=4. The minority of pregnant women who attend the DANCE clinic at Alice Springs Hospital received DR screening in adherence with national guidelines.