title: Impact of birth parameters and early life growth patterns on retinal microvascular structure in children: The Generation R Study.
abstract: OBJECTIVE
  The aim of the study was to examine the associations of birth outcomes and longitudinally measured fetal and infant growth patterns with retinal vessel calibers in childhood.
  
  
  METHODS
  In a population-based prospective cohort study among 4122 children, we measured growth characteristics in second and third trimester of pregnancy, at birth, and at 6, 12, 24, 36, 48, and 72 months. At the age of 6 years, we measured retinal arteriolar and venular calibers from digitized retinal photographs.
  
  
  RESULTS
  We observed that compared with term-born children, those born preterm had narrower retinal arteriolar caliber [differences -0.46 standard deviation score (95% confidence interval -0.77 to -0.15) and -0.24 standard deviation score (95% confidence interval -0.42 to -0.05) for children born <34 and 34-37 weeks of gestation, respectively]. Children born with a low birth weight (<2500  g) had narrower retinal arteriolar caliber than children with a normal birth weight, but this association was fully explained by gestational age at birth. Accelerated infant growth until 24 months was associated with narrow retinal arteriolar caliber, especially among preterm-born children (P < 0.05). Early growth measures were not associated with retinal venular caliber.
  
  
  CONCLUSIONS
  Preterm birth and accelerated infant growth are associated with narrower retinal arteriolar caliber in childhood. Whether these microvascular adaptations explain the well known associations of fetal and infant characteristics with cardiovascular disease in later life should be further studied.
authors: aThe Generation R Study Group bDepartment of Pediatrics cDepartment of Obstetrics and Gynecology dDepartment of Neonatology eDepartment of Epidemiology fDepartment of Ophthalmology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands gSingapore Eye Research Institute hDuke-NUS Graduate Medical School, National University of Singapore, Memory Aging & Cognition Centre iNational University of Health System, Singapore, Singapore.
authors: Olta
authors: O
authors: Gishti
authors: Vincent W V
authors: VW
authors: Jaddoe
authors: Liesbeth
authors: L
authors: Duijts
authors: Eric
authors: E
authors: Steegers
authors: Irwin
authors: I
authors: Reiss
authors: Albert
authors: A
authors: Hofman
authors: Tien Y
authors: TY
authors: Wong
authors: Mohammad K
authors: MK
authors: Ikram
authors: Romy
authors: R
authors: Gaillard
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D012160:Retina / Q000002:abnormalities* / Q000254:growth & development*; D012171:Retinal Vessels / Q000002:abnormalities* / Q000254:growth & development*; D012307:Risk Factors