Preconception maternal retinal venular widening and steeper resistance increments in the utero-fetoplacental circulation in pregnancy
Ling-Jun Li,
Mosammat Nazmun Nahar,
Ruochen Du,
Jerry Kok Yen Chan,
June Vic Khi Tan,
Johan G. Eriksson,
Tien Yin Wong,
Shiao-Yng Chan,
Lin Lin Su,
Yap Seng Chong,
Cuilin Zhang
Affiliations
Ling-Jun Li
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Global Centre for Asian Women’s Health, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore; Corresponding author
Mosammat Nazmun Nahar
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Ruochen Du
Biostatics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Jerry Kok Yen Chan
Duke-NUS Medical School, Singapore, Singapore; Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
June Vic Khi Tan
Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
Johan G. Eriksson
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Human Potential Translational Research Programme (TRP), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Folkhälsan Research Center, Helsinki, Finland; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
Tien Yin Wong
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
Shiao-Yng Chan
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore, Singapore
Lin Lin Su
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Yap Seng Chong
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Global Centre for Asian Women’s Health, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Cuilin Zhang
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Global Centre for Asian Women’s Health, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; NUS Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
Summary: We investigated the relationship of preconception maternal retinal vasculature and utero-fetoplacental circulation in ensuing pregnancy. Embedded in a hospital-based, prospective preconception cohort, 396 women with a singleton live birth were included for analysis. We assessed retinal vascular caliber during preconception phase and retrieved ultrasonogram results documenting utero-fetoplacental circulatory indices using Doppler ultrasonography and documented them at 18–21 weeks, 24–28 weeks, and 32–34 weeks where available. We performed a modified Poisson regression to estimate the relative risk of utero-fetoplacental abnormalities, adjusting for major confounders including pre-pregnancy and blood pressure. Per 10 μm increment in maternal preconception retinal venules was associated with over two-fold risks in developing notching (Relative risk [RR]: 2.84; 95% confidence interval [CI]: 1.79, 4.81) and ≥95th percentile umbilical artery pulsatility index (2.36; 1.72, 3.23) during mid-to-late pregnancy, respectively. Women with preconception retinal venular widening tended to demonstrate steeper resistance increments in both maternal uterine arteries and fetal umbilical arteries during mid-to-late pregnancy.
