方法：通过糖尿病筛查确诊的妊娠期糖尿病(GDM)伴糖尿病视网膜病变(DR)孕妇28例(A组)，GDM不伴DR孕妇28例(B组)，正常孕妇28例(C组)，分别在妊娠6，9mo和产后6mo对三组孕妇进行视力、眼底照相、糖化血红蛋白(HbAlc)等检查。

结果：GDM的发病率为5.6%，妊娠期DR的发生率为16.7%，妊娠期DR的进展率为39.3%。在妊娠9mo时，A组的平均最佳矫正视力(BCVA)低于B组和C组(P<0.05)，B组和C组的视力无统计学差异(P>0.05)； A组平均最佳矫正视力(BCVA)在妊娠9mo低于妊娠6mo和产后6mo(P<0.05)。妊娠6，9mo和产后6mo，HbAlc为A组>B组>C组(P<0.05)。

结论：妊娠会促进DR进展，可能与血中HbAlc增高有关，密切观察和严格控制血糖，能够有效减低糖尿病孕妇的视力损害。

METHODS: Eighty-four gravidas were enrolled in this prospective study. The patients were divided into three groups, group A consisting of 28 gravidas with gestational diabetic mellitus(GDM)with DR, group B consisting of 28 gravidas with GDM alone, and group C consisting of 28 normal gravidas. The best corrected visual acuity(BCVA)and glycosylated hemoglobin(HbA1c)were determined and fundus photography was performed at 6, 9 months of pregnancy and 6 months after parturition respectively.

RESULTS: During pregnancy, the morbidity of GDM and DR was respectively 5.6% and 16.7%; the progress rate of gestational DR was 39.3%. At 9 months of pregnancy, the mean BCVA of group A was significantly poorer than that of group B or C(P<0.05)while there was no significant difference in BCVA between group B and C(P>0.05). The BCVA of group A at 9 months of pregnancy was poorer than that at 6 months of pregnancy or 6 months after parturition. At all times, the mean level of HbAlc of group A were significantly higher than that of group B or C(P<0.05).

CONCLUSION: DR progressing during pregnancy may be related to the increased HbAlc level, so close monitoring and control of blood glucose may help to reduce the visual impairment among DM gravidas.