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Abnormal retinal vascular morphology in young adults following intrauterine growth restriction
Ann Hellström1, Jovanna Dahlgren, Karel Marsál
1Department of Clinical Neurosciences, Section of Ophthalmology, Sahlgrenska Academy, Gothenburg, Sweden. ann.hellstrom@medfak.gu.se
Insights
Intrauterine growth restriction (IUGR) with abnormal fetal blood flow is linked to altered retinal vascular development in young adults. This suggests potential long-term cardiovascular risks associated with impaired fetal growth.
Area of Science:
- Ophthalmology
- Perinatology
- Cardiovascular Medicine
Background:
- Intrauterine growth restriction (IUGR) and low birth weight are associated with increased risks of adult cardiovascular disease.
- Abnormal fetal blood flow patterns in IUGR can indicate true fetal growth impairment.
- Retinal vascular morphology may serve as an indicator of long-term vascular health.
Purpose of the Study:
- To investigate the association between intrauterine growth restriction (IUGR) with abnormal fetal blood flow and retinal vascular morphology in young adulthood.
- To determine if abnormal fetal blood flow in IUGR correlates with changes in retinal vasculature by age 18.
Main Methods:
- Prospective study of 21 subjects with IUGR (abnormal fetal aortic blood flow velocity, small for gestational age) and 23 controls (normal fetal aortic blood flow velocity, appropriate for gestational age).
- Birth weight deviation from the population mean was recorded for both groups.
- Retinal vessel morphology was assessed using digital image analysis.
Main Results:
- Subjects with IUGR exhibited significantly reduced retinal vascularization, indicated by fewer vascular branching points (median 26 vs. 28).
- A negative birth weight deviation was correlated with a reduced number of vascular branching points (r = 0.36).
Conclusions:
- Intrauterine growth restriction (IUGR) accompanied by abnormal fetal blood flow is associated with abnormal retinal vascular morphology in young adults.
- These findings highlight a potential link between early-life growth conditions and later vascular health.
Objective:
Intrauterine growth restriction (IUGR) resulting in low birth weight for gestational age may predispose one to development of cardiovascular disease later in life. Abnormal fetal blood flow in the presence of fetal growth restriction helps to distinguish infants with true fetal growth impairment from small but normal infants. Our goal was to investigate associations between IUGR with abnormal fetal blood flow and abnormal retinal vascular morphology at 18 years of age.
Methods:
A prospective study was performed with 21 subjects with IUGR (abnormal fetal aortic blood flow velocity; birth weight small for gestational age; median birth weight deviation from the population mean of -31% [range: -22% to -42%] and in 23 subjects with birth weight appropriate for gestational age [normal fetal aortic blood flow velocity; median birth weight deviation of -2% (range: -10% to 22%)]). The retinal vessel morphology was evaluated by digital image analysis.
Result:
Subjects with IUGR (n = 21) had significantly less retinal vascularization as evidenced by a lower number of vascular branching points (median: 26; range: 20-31) as compared with the subjects who were born appropriate for gestational age (median: 28; range: 26-32). Within the entire group (N = 44), increasing negative birth weight deviation was associated with a reduced number of vascular branching points (r = 0.36.
Conclusion:
Our findings show that IUGR with abnormal fetal blood flow is associated with abnormal retinal vascular morphology in young adult life.
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