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

Objective: 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. Methods: We collected detailed information on sociodemographic status, pregnancy history and lifestyle, and performed retinal imaging at the preconception visit. Main outcome measures: 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. Results: 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. Conclusions: Our findings suggest that women with narrower preconception retinal arterioles had smaller fetuses, evidenced by reductions in AC and FL z score throughout pregnancy. Linked article: This article is commented on by Veronica Giorgione, pp. 288‐289 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471‐0528.17666 [ABSTRACT FROM AUTHOR]