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Changes in Retinal Microvasculature During Healthy Pregnancy Measured by AO
Anne Dathan-Stumpf1, Emilie Martini1, Holger Stepan1
1Department of Obstetrics, Leipzig University Hospital, Germany (A.D.-S., E.M., H.S.).
Hypertension (Dallas, Tex. : 1979)
|June 29, 2026
Summary
This study reveals that the wall-to-lumen ratio (WLR) in retinal microvasculature increases during normal pregnancy, reflecting vascular adaptation. Maternal age and blood pressure influence this change, highlighting WLR as a sensitive marker for pregnancy-related microvascular remodeling.
Area of Science:
- Ophthalmology
- Cardiovascular Research
- Reproductive Medicine
Background:
- Adaptive optics retinal imaging offers high-resolution views of retinal microvasculature, crucial for assessing systemic vascular health.
- No prior studies have documented changes in the wall-to-lumen ratio (WLR) during pregnancy or pregnancy complications.
Purpose of the Study:
- To investigate changes in retinal microvasculature, specifically the wall-to-lumen ratio (WLR), throughout normal pregnancy.
- To identify factors influencing WLR during gestation using adaptive optics technology.
Main Methods:
- A prospective, single-center study involving 460 healthy pregnant women.
- Adaptive optics imaging was used to measure the WLR of retinal arterioles, with measurements taken from the first to third trimesters.
- The nnUNet deep learning model automatically calculated WLR, and mixed-effects modeling analyzed influencing factors.
Main Results:
- Gestational week, maternal age, and mean arterial pressure were significant predictors of increased WLR.
- Parity influenced WLR, with multiparous women exhibiting lower values compared to nulliparous women.
- Body mass index did not significantly improve the model predicting WLR.
Conclusions:
- Wall-to-lumen ratio (WLR) is a sensitive indicator of microvascular remodeling and adaptation during physiological pregnancy.
- An increase in WLR signifies an immediate change in retinal microvasculature during normal pregnancy.
- Further research is needed to explore postpartum WLR changes and their reversibility.
