title: Associations of maternal retinal vasculature with subsequent fetal growth and birth size.
abstract: OBJECTIVE
  We aimed to study the maternal retinal microvasculature at mid-trimester and its relationship with subsequent fetal growth and birth size.
  
  
  METHODS
  We recruited 732 pregnant women aged 18-46 years in the first trimester with singleton pregnancies. All had retinal photography and fetal scan performed at 26-28 weeks gestation, and subsequent fetal scan at 32-34 weeks gestation. Infant anthropometric measurements were done at birth. Retinal microvasculature was measured using computer software from the retinal photographs.
  
  
  RESULTS
  In multiple linear regression models, each 10 μm narrowing in maternal retinal arteriolar caliber was associated with decreases of 1.36 mm in fetal head circumference at 32-34 weeks gestation, as well as decreases of 1.50 mm and 2.30 mm in infant head circumference and birth length at delivery, respectively. Each standard deviation decrease in maternal retinal arteriolar fractal dimension was associated with decreases of 1.55 mm in fetal head circumference at 32-34 weeks gestation, as well as decreases of 1.08 mm and 46.42 g in infant head circumference and birth weight at delivery, respectively.
  
  
  CONCLUSIONS
  Narrower retinal arteriolar caliber and a sparser retinal vascular network in mothers, reflecting a suboptimal uteroplacental microvasculature during mid-pregnancy, were associated with poorer fetal growth and birth size.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors.forename: Ling-Jun
authors.initials: LJ
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Izzuddin
authors.initials: I
authors.lastname: Aris
authors.affiliation: Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Lin Lin
authors.initials: LL
authors.lastname: Su
authors.affiliation: Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Mya Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; DUKE-NUS Graduate Medical School, Singapore.
authors.forename: Carol Yim-Lui
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Departments of Epidemiology & Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands; Memory Aging & Cognition Centre, National University Health System, Singapore.
authors.forename: M Kamran
authors.initials: MK
authors.lastname: Ikram
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.
authors.forename: Peter
authors.initials: P
authors.lastname: Gluckman
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton, Biomedical Research Centre, University of Southampton, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: KK Women's and Children's Hospital, Singapore.
authors.forename: Kok Hian
authors.initials: KH
authors.lastname: Tan
authors.affiliation: KK Women's and Children's Hospital, Singapore.
authors.forename: George
authors.initials: G
authors.lastname: Yeo
authors.affiliation: KK Women's and Children's Hospital, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton, Biomedical Research Centre, University of Southampton, Southampton, United Kingdom.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kwek
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tien-Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D047109:Fetal Development; D005451:Fluorescein Angiography; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D055806:Microvessels; D008875:Middle Aged; D011247:Pregnancy; D012171:Retinal Vessels; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D055815:Young Adult