Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
BJOG. 2024 Feb;131(3):278-287. doi: 10.1111/1471-0528.17621. Epub 2023 Jul 28.
To investigate the association between preconception maternal retinal arteriolar calibre and fetal growth.
DESIGN, SETTING AND POPULATION: A hospital-based, prospective preconception cohort including 369 women with a singleton live birth.
We collected detailed information on sociodemographic status, pregnancy history and lifestyle, and performed retinal imaging at the preconception visit.
We 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.
Maternal 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.
Our findings suggest that women with narrower preconception retinal arterioles had smaller fetuses, evidenced by reductions in AC and FL z score throughout pregnancy.
探讨孕前母亲视网膜小动脉口径与胎儿生长的关系。
设计、地点和人群：这是一项基于医院的前瞻性孕前队列研究，纳入了 369 名单胎活产的女性。
我们在孕前就诊时收集了详细的社会人口统计学状况、妊娠史和生活方式信息，并进行了视网膜成像。
我们查阅了记录胎儿生长生物标志物（如腹围[AC]、头围[HC]、股骨长[FL]）的病历，这些生物标志物在整个孕期的 11-13、18-21、24-28 和 32-34 孕周进行测量。然后，我们根据 INTERGROWTH-21st 胎儿生长图表，计算了从 14 孕周开始的所有胎儿生长生物标志物的 z 分数，这些数据是可用的。我们使用线性混合模型估计了孕前母亲视网膜小动脉口径与整个孕期胎儿生长生物标志物 z 分数之间的关系，随机截距考虑了个体内的重复测量。然后，我们在充分调整后，对 24-28 孕周和 32-34 孕周之间所有胎儿生长生物标志物的孕前母亲视网膜小动脉口径和 z 分数变化进行了多变量线性回归。
孕前普遍存在的视网膜小动脉变窄与整个孕期胎儿 AC z 分数的降低（-0.34；95%CI-0.66 至-0.03）有关。此外，孕前普遍存在的视网膜小动脉变窄的女性，其 AC 和胎儿 FL 的 z 分数变化分别在 24-28 孕周和 32-34 孕周时显著降低（AC：-0.41；95%CI-0.90 至-0.001；FL：-0.55；95%CI-1.00 至-0.10）。
我们的研究结果表明，孕前视网膜小动脉较窄的女性胎儿较小，表现在整个孕期 AC 和 FL z 分数的降低。
