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Impact of birth parameters and early life growth patterns on retinal microvascular structure in children: The
Olta Gishti1, Vincent W V Jaddoe, Liesbeth Duijts
1aThe 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.
Insights
Preterm birth and rapid infant growth are linked to narrower retinal arterioles in children. These findings suggest potential early indicators for later cardiovascular health risks.
Area of Science:
- Ophthalmology
- Pediatrics
- Developmental Biology
Background:
- Retinal vessel caliber is a potential indicator of systemic vascular health.
- Birth outcomes and early growth influence long-term health trajectories.
Purpose of the Study:
- To investigate the association between birth outcomes, fetal and infant growth patterns, and retinal vessel calibers in childhood.
Main Methods:
- A population-based prospective cohort study of 4122 children.
- Growth measurements taken during pregnancy, at birth, and up to 72 months.
- Retinal arteriolar and venular calibers measured at age 6 years.
Main Results:
- Preterm birth was associated with narrower retinal arteriolar caliber.
- Low birth weight association with narrower arterioles was explained by gestational age.
- Accelerated infant growth by 24 months correlated with narrower arterioles, particularly in preterm infants.
Conclusions:
- Preterm birth and accelerated infant growth are linked to narrower retinal arteriolar caliber in children.
- Further research is needed to determine if these microvascular changes predict future cardiovascular disease.
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.
Conclusion:
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.
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