• Laura Benschop, Sarah Schalekamp-Timmermans, Jeanine E Roeters van Lennep, JaddoeVincent W VVWVDepartment of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.Department of Pediatrics, Erasmus Medical Center, Rotterdam, the Netherlands., Tien Yin Wong, Carol Y Cheung, SteegersEric A PEAPDepartment of Obstetrics and Gynecology, Erasmus Medical Center, Wytemaweg 80, PO Box 2040, 3000 CA, Rotterdam, the Netherlands., and M Kamran Ikram.
• Department of Obstetrics and Gynecology, Erasmus Medical Center, Wytemaweg 80, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. h.benschop@erasmusmc.nl.
• Bmc Med. 2017 Aug 14; 15 (1): 153.

BackgroundChanges in the microvasculature associated with pre-eclampsia and gestational hypertension have been proposed as a potential pathway in the development of cardiovascular disease. We examined whether gestational hypertensive disorders, such as pre-eclampsia and gestational hypertension, are related to the maternal retinal microvasculature status after pregnancy.MethodsThis study is part of an ongoing population-based prospective cohort study. During pregnancy and 6.2 years after the index pregnancy (90% range 5.7-7.4 years), we examined 3391 women with available information on pre-eclampsia, gestational hypertension, and retinal vascular calibers. Retinal arteriolar and venular calibers were measured in the left eye from digitized retinal photographs.ResultsWomen with pre-eclampsia had smaller retinal arteriolar calibers 6 years after pregnancy than women with a normotensive pregnancy (adjusted difference: -0.40 standard deviation score [SDS]; 95% confidence interval [CI]: -0.62, -0.19). For women with previous gestational hypertension, similar trends were observed (-0.20 SDS; 95% CI: -0.34, -0.05). With respect to retinal venular calibers, we did not observe consistent trends for women with previous pre-eclampsia. However, in women with previous gestational hypertension, we observed larger venular calibers (0.22 SDS; 95% CI: 0.07-0.36) than in women with a previous normotensive pregnancy. The association of gestational hypertensive disorders with retinal vessel calibers was mediated through mean arterial pressure at the time of retinal imaging.ConclusionsCompared to women with a previous normotensive pregnancy, women with pre-eclampsia and gestational hypertension show an altered status of the microvasculature 6 years after the index pregnancy. This is reflected by smaller retinal arteriolar calibers and wider retinal venular calibers. These microvascular changes may possibly contribute to the development of cardiovascular disease in later life.

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