NEWS

Children of Mothers with Diabetes While Pregnant Have Higher Risk of Vision Problems

A child stares at a vision test.

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Key Takeaways

  • A recent study linked vision problems in children with being exposed to diabetes during their time in utero.
  • The study showed an increased risk of high refractive error, which can lead to medical conditions that impact the eye's ability to focus on objects.
  • Having diabetes during pregnancy does not mean your baby will necessarily be born with an eye problem.

If you are pregnant and living with diabetes, controlling your health can be stressful as you worry about health implications for you and your child. A recent study analyzed a potential link between diabetes in pregnancy and babies born with vision problems. While it can seem like just one more thing to worry about, it’s simply an increased risk to watch out for as your baby grows. Here’s what researchers found.

The Study Results

The study, published in Diabetologia, analyzed 2,470,580 babies’ development through age 25 (in most cases) to determine the connection between the birthing parent’s diabetes and the child’s increased risk of developing a vision problem.

The findings indicated that mothers with diabetes, including Type 1, Type 2, or gestational, had babies with a higher risk of vision problems due to higher refractive error (RE). This means that the eye fails to properly focus images on the retina.

Of all of those babies, 2.3% were exposed to diabetes. These babies had a 39% greater risk of high RE compared to the other babies. Babies from birthing parents with type 1 diabetes had a 32% higher risk, and those with type 2 had a 68% higher risk. In addition, if there were complications during the pregnancy related to diabetes, children in these situations had double the risk.

How Concerned You Should be About High Refractive Error

While RE sounds a bit scary, and we all want our children to have optimal vision throughout their lives, it’s important to know what a higher risk of RE really means. Robert Clark, MD, pediatric ophthalmologist at MemorialCare Miller Children’s & Women’s Hospital in Long Beach, Calif., says that high refractive error is not a medical condition, but rather a risk for developing a medical condition. 

Robert Clark, MD

Many people, myself included, have high refractive errors and enjoy many years of clear, comfortable vision with glasses or contact lenses,

— Robert Clark, MD

“[RE] is caused by an abnormal shape of the eye, a mismatch between the focusing elements of the eye (cornea and lens) and light-sensing part of the eye (retina). Many people, myself included, have high refractive errors and enjoy many years of clear, comfortable vision with glasses or contact lenses,” Dr. Clark says. "Babies born to mothers with diabetes are [typically] larger and heavier than those born to non-diabetic mothers, and those physical differences likely translate to the eye growth itself, causing a mismatch in the shape of the eye and its focusing elements.”

So, even if you have a pregnancy with diabetes, your baby isn’t more likely to be born with an actual medical condition, but rather at an increased risk for developing one, according to this study.

Testing to Have Done for Babies with Increased Risk

When your baby is born, a pediatrician already performs a standard eye test of the “red reflex” which involves examining the baby’s eyes to look for an equal and bright red reflex from each pupil.

“Whether or not a mother is diabetic, all babies should have their eyes evaluated at birth, checking for abnormalities of the eyelids or eyeballs, checking for full movement of each eye, checking for symmetry of appearance of the eyes, and checking for symmetry of the 'red reflex,'" says Howard R. Krauss, MD, is a neuro-ophthalmologist and Clinical Professor of Ophthalmology and Neurosurgery at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif.

For premature babies, this is done by an ophthalmologist. Other babies will have this exam done by a pediatrician. “Any detected abnormality or asymmetry should lead to an Ophthalmologic consultation in the hospital nursery," he notes. 

Howard Krauss, MD

Whether or not a mother is diabetic, all babies should have their eyes evaluated at birth.

— Howard Krauss, MD

From there, your child’s pediatrician should be doing eye exams on a regular basis, he explains, even when there aren’t any questions or complaints. Dr. Clark says that the pediatrician will use a photo-based screening to help identify eye concerns with children who are pre-verbal or nonverbal “quite reliably.”

Signs to Watch for at Home

You can also do some at home informal “testing” yourself, according to Dagny Zhu, MD, board-certified ophthalmologist and Medical Director of NVISION Rowland Heights. Dr. Zhu recommends watching for the following signs:

  • Inability to track objects or make eye contact by 3 months of age
  • Wandering eyes or crossing eyes
  • Unusual head tilting when viewing something
  • Squinting at the TV or far away objects, for older children

“Most children do not need to wear glasses for farsightedness as their focusing power is so strong, they can overcome the farsightedness and see clearly," Dr. Zhu says. "As the eye grows larger as the child ages, the farsightedness decreases in many cases and the eye may actually become nearsighted if it grows too long. Nearsightedness usually starts and progresses around age 6 in school-age children and will require glasses.”

What You Can Do During Pregnancy To Prevent Eye Issues

If you have diabetes and are pregnant, the best thing you can do, according to all of our experts, is to work frequently and thoroughly with your OBGYN to properly control blood sugar. In addition, if you had diabetes during your pregnancy, ensure your child's healthcare providers are completing vision exams periodically.

You can also bring up your concern about the potential link between diabetes and their vision so they can be sure to monitor it going forward.

What This Means for You

If you have diabetes while you are pregnant, make sure your baby is getting initial and follow-up eye vision tests from their early days on. You don't have to do anything additionally to ensure your baby's health, other than working with your OBGYN to keep your blood sugar in check throughout the pregnancy. Children who do have a higher refractory error may have an increased risk of vision issues later, but do not always have a problem.

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2 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. u, J., Li, J., Liu, X. et al. Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort studyDiabetologia (2021). doi:10.1007/s00125-021-05526-z

  2. Toli A, Perente A, Labiris G. Evaluation of the red reflex: An overview for the pediatrician. World Journal of Methodology. 2021;11(5). doi:10.5662/wjm.v11.i5.263