Thinning of specific retinal layers as a novel biomarker for adverse outcomes in high-risk pregnancy

To investigate a potential association between retinal layer thinning and pregnancy-related adverse outcomes.

A prospective observational study included 32 pregnant women between the ages of 18 and 45. Seventeen had uneventful pregnancies, and 15 experienced an adverse obstetrical outcome. Macular swept-source ocular coherence tomography was performed, and selective layers of the retina were evaluated. Adverse obstetrical outcome was defined as any of the following: preterm delivery, preeclampsia, pregnancy-induced hypertension, elevated liver function tests, thrombocytopenia and need for magnesium.

The inner superior ganglion cell layer (GCL) was found to be thinner in the cohort with composite adverse obstetrical outcomes than in the cohort without complications (84.5±6.9 vs. 89.5±6.1μm respectively; P=0.04). Total inner superior (295.5±39.1 vs. 302.5±12.7μm; P=0.03) and inferior retinal thickness (289.0±13.9 vs. 301.0±17.1μm; P=0.03) as well as total macular volume (7.5±0.3 vs. 7.7±0.3 mm³; P=0.02) were also lower in women with adverse obstetrical outcomes.

Thinning of the macular ganglion cell layer was associated with adverse outcomes in pregnancy. Larger studies are necessary to assess the potential role of macular GCL analysis in pregnancy.