Retinal microvasculature and risk of spontaneous abortion in multiethnic Southeast Asian women

Li, Ling‐Jun; Du, Rongguang; Loy, See Ling; Chong, Yap Seng; Chan, Jerry Kok Yen; Wong, Tien Yin; Eriksson, Johan G.; Huang, Zhongwei; Zhang, Cuilin

doi:10.1016/j.fertnstert.2022.06.033

Cited by 5 publications

(5 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed a series of exciting associations between suboptimal retinal microvascular features (e.g., narrowing arterioles, widening venules, sparse fractal, enlarged vascular branching angle, higher vascular curvature tortuosity) and common determinants of fetal growth such as maternal obesity, 46 gestational diabetes mellitus, 26 hypertensive disorder during pregnancy risk, 20 psychological stress 47 and nutrition intake in pregnant women 48 . Novel work in this SPRESTO preconception cohort also identified biologically plausible relationships of suboptimal retinal vascular geometry (e.g., sparser arteriolar fractal, higher arteriolar and venular curvature tortuosity) with prolonged time‐to‐pregnancy, 29 and incident spontaneous abortion 49 . Hence, retinal microcirculation might indicate overall female cardiometabolic and reproductive health and potentially reflect the general uteroplacental and ovarian–uterine circulation.…”

Section: Discussionmentioning

confidence: 80%

“…48 Novel work in this SPRESTO preconception cohort also identified biologically plausible relationships of suboptimal retinal vascular geometry (e.g., sparser arteriolar fractal, higher arteriolar and venular curvature tortuosity) with prolonged time-to-pregnancy, 29 and incident spontaneous abortion. 49 Hence, retinal microcirculation might indicate overall female cardiometabolic and reproductive health and potentially reflect the general uteroplacental and ovarian-uterine circulation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preconception maternal retinal arteriolar narrowing and fetal growth throughout pregnancy: A prospective cohort study

Chan

et al. 2023

BJOG

Self Cite

View full text Add to dashboard Cite

ObjectiveTo investigate the association between preconception maternal retinal arteriolar calibre and fetal growth.Design, setting and populationA hospital‐based, prospective preconception cohort including 369 women with a singleton live birth.MethodsWe collected detailed information on sociodemographic status, pregnancy history and lifestyle, and performed retinal imaging at the preconception visit.Main outcome measuresWe retrieved medical records documenting fetal growth biometrics (e.g., abdominal circumference [AC], head circumference [HC], femur length [FL]) at 11–13, 18–21, 24–28, and 32–34 weeks throughout pregnancy. We then computed the z scores for all fetal growth biometrics from 14 weeks of gestation where data were available, referencing the INTERGROWTH‐21st fetal growth chart. We used a linear mixed model to estimate the association between maternal preconception retinal arteriolar calibre and fetal growth biometrics z scores throughout pregnancy, with random intercept accounting for repeated measures within individuals. We then performed a multivariable linear regression of maternal preconception retinal arteriolar calibre and z score changes for all fetal growth biometrics between 24–28 weeks and 32–34 weeks of gestation, after full adjustment.ResultsMaternal preconception generalised retinal arteriolar narrowing was consistently associated with a reduction in fetal AC z scores (−0.34; 95% CI −0.66 to −0.03) throughout pregnancy. In addition, women with preconception generalised retinal arteriolar narrowing tended to have significantly reduced z score changes in AC (−0.41; 95% CI −0.90 to −0.001) and fetal FL (−0.55; 95% CI −1.00 to −0.10) between 24–28 weeks and 32–34 weeks of gestation, respectively.ConclusionsOur findings suggest that women with narrower preconception retinal arterioles had smaller fetuses, evidenced by reductions in AC and FL z score throughout pregnancy.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Preconception maternal retinal arteriolar narrowing and fetal growth throughout pregnancy: A prospective cohort study

Chan

et al. 2023

BJOG

Self Cite

View full text Add to dashboard Cite

show abstract

“…Therefore, the curvature of retinal vessels could be used as a referenced parameter for some vascular diseases, such as retinopathy of prematurity, hypertension, and cerebrovascular diseases ( 41 , 48 , 53 ). It can also provide a possible correlation between conditions in utero or early life and adult life ( 54 ). Once the curvature of retinal vessels changed, pathological conditions may emerge and more attention on disease monitoring would be needed.…”

Section: Discussionmentioning

confidence: 99%

Optic disc and retinal vascular features in first 6 years of Chinese children

et al. 2023

View full text Add to dashboard Cite

PurposeRetinal microvasculature plays an important role in children's fundus lesions and even in their later life. However, little was known on the features of normal retina in early life. The purpose of this study was to explore the normal retinal features in the first 6 years of life and provide information for future research.MethodsChildren, aged from birth to 6 years old and diagnosed with various unilateral ocular diseases were included. Venous phase fundus fluorescein angiography images with the optic disc at the center were collected. Based on the ResUNet convolutional neural network, optic disc and retinal vascular features in the posterior retina were computed automatically.ResultsA total of 146 normal eyes of 146 children were included. Among different age groups, no changes were shown in the optic disc diameter (y = −0.00002x + 1.362, R2 = 0.025, p = 0.058). Retinal vessel density and fractal dimension are linearly and strongly correlated (r = 0.979, p < 0.001). Older children had smaller value of fractal dimension (y = −0.000026x + 1.549, R2 = 0.075, p = 0.001) and narrower vascular caliber if they were less than 3 years old (y = −0.008x + 84.861, R2 = 0.205, p < 0.001). No differences were in the density (y = −0.000007x + 0.134, R2 = 0.023, p = 0.067) and the curvature of retinal vessels (lnC = −0.00001x − 4.657, R2 = 0.001, p = 0.667).ConclusionsAge and gender did not impact the optic disc diameter, vessel density, and vessel curvature significantly in this group of children. Trends of decreased vessel caliber in the first 3 years of life and decreased vessel complexity with age were observed. The structural characteristics provide information for future research to better understand the developmental origin of the healthy and diseased retina.

show abstract

“…25 In ensuing pregnancies, individuals with higher preconception and greater arteriolar and venular curvature tortuosity encountered a 25-34% increased risk of spontaneous abortion before 20 weeks' gestation. 26 The underlying pathophysiology, characterized by vascular inflammation, 27,28 hypoxia, 15,16 oxidative stress, 29 endothelial dysfunction, [30][31][32] and impaired uterine perfusion, 33,34 contributes to both reduced fecundability and spontaneous abortion, in addition to common risk factors like advanced maternal age, 35,36 stress, 37 cigarette smoking, 38 medication or substance use, 39,40 medical conditions, [41][42][43] and environmental pollution. 44 Women's antenatal health…”

Section: Women's Fertilitymentioning

confidence: 99%

Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions

Lim,

2024

Maternal Fetal Med

Self Cite

View full text Add to dashboard Cite

Over the past two decades, population-based studies employing semiautomatic computer-assisted programs have uncovered associations between retinal microvascular features and various systemic conditions. As the recognition of retinal imaging in cardiometabolic health grows, there is increasing evidence supporting its application in women’s health, particularly during the reproductive age. This review aims to summarize the indications of retinal imaging in women’s health and intergenerational health, where suboptimal retinal imaging has been found to mirror pathological systemic changes, such as suboptimal hemodynamic circulation, inflammation, endothelial dysfunction, oxidative stress, and hypoxia in vivo. Findings from Singapore Growing Up in Singapore Towards Healthy Outcomes and Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohorts have reported serial changes in retinal conventional microvascular features (e.g., retinal arteriolar narrowing, retinal venular widening) and retinal geometric microvascular features (e.g., sparse fractal dimension, enlarged branching angle, and increased curvature tortuosity) during the preconception and antenatal phases. These morphological abnormalities were found to be related to female fertility, maternal antenatal health conditions, postnatal maternal cardiometabolic health, and intergenerational health in the fetus. Given the compelling evidence of the ability to detect microvascular changes through noninvasive methods at an early stage, retinal imaging holds the potential to facilitate timely interventions, mitigate the progression of complications, and prevent adverse pregnancy outcomes. Looking ahead, the convergence of artificial intelligence and advanced imaging techniques heralds a promising era in women’s health research and clinical practice.

show abstract

Retinal microvasculature and risk of spontaneous abortion in multiethnic Southeast Asian women

Cited by 5 publications

References 60 publications

Preconception maternal retinal arteriolar narrowing and fetal growth throughout pregnancy: A prospective cohort study

Preconception maternal retinal arteriolar narrowing and fetal growth throughout pregnancy: A prospective cohort study

Optic disc and retinal vascular features in first 6 years of Chinese children

Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions

Contact Info

Product

Resources

About