HYBRID EVENT: You can participate in person at Boston, Massachusetts, USA or Virtually from your home or work.
Maureen Groer, Speaker at Diabetes Conferences
University of Tennessee Knoxville, United States
Title : Diabetic retinopathy and GDM in hispanic pregnant women with toxoplasma gondii


Retinal photography was performed in pregnancy and  postpartum in pregnant Hispanic women with latent Toxoplasma gondii (TG) infection (N=158)  A comparison group of TG negative women  (N=532) was included for data from the electronic health record (EHR).The goal  was to assess for parasite reactivation in TG positive (TG+) women as evidenced by characteristic lesions, so retinal photography, usually at prenatal visits 2 (17 +/- 3.35 weeks) and 3 ( 26.3+/-1.75) weeks, were done on TG+ women. Fifty six (43%) had retinal photography at the postpartum visit.

From the 690 recruited at the first prenatal visit, 128 TG– women and 158 TG+ women were enrolled in a prospective study. The TG- women (N=404) not enrolled in the prospective study provided data at the first prenatal visit and throughout their pregnancy and birth through the EHR. This allowed comparison of health and outcome data for the TG+ compared to a larger number of TG- Hispanic pregnant women.

While there was no evidence of reactivation of ocular toxoplasmosis during pregnancy, there was a surprisingly large number  (42%) of TG+ women with diabetic retinopathy (DR). We also observed that TG+ women had a 20% incidence of gestational diabetes mellitus (GDM) compared to 11.3% in the TG- women (p = 0.01). At postpartum  (mean 5.6 weeks), 23 of 30 women with DR showed no DR in the postpartum. These data suggest that chronic TG infection was associated with increased incidence of GDM, and that, in general, Hispanic pregnant women’s risk for latent TG infection, diabetes, and DR are underappreciated. Retinal photography may need to be considered an innovative approach to screening.

Audience Take Away: 

  • The increasing need to screen for GDM in the Hispanic population, particularly in those who are TG positive
  • GDM is diagnoses with standard criteria, requiring both 1 hour and 3 hour tests to be positive, but we found retinopathy in women with an abnormal 1 hour and normal 3 hour test.
  • The presence of diabetic retinopathy in pregnancy may unmask a pre-diabetic state
  • Diabetic retinopathy could provide a window into the vascular changes of pregnancy in other organs


Dr. Maureen Groer is a professor in the College of Nursing at the University of Tennessee, Knoxville. Before this position, which she began in 2023, she was a Distinguished University Professor at the University of South Florida. Her work has focused on pregnancy and the postpartum with research areas in immunology, infectious disease, and the microbiome. She has had several large NIH grants, has over 140 publication, and has an H index of 41.