Exploring retinal biomarkers as novel predictors of pregnancy complications including stillbirth

Every 16 seconds one baby is stillborn. That amounts to more than two million stillborn babies globally every year. Stillbirths have long-lasting personal and psychological consequences for parents and families, as well as substantial costs for wider society.

Stillbirth is the endpoint of a number of different processes that involve the mother, baby, the placenta - or a combination of the three. The lack of methods to assess gestational development in utero limits our ability to predict the risk of stillbirth. Today 25-50% of stillbirths are unexplained - meaning that no conditions that affect the mother, baby, or placenta that could contribute to the baby's death are identified.

The eye provides a unique "window" to detect microvascular changes through analysis of images showing the retinal and choroidal microvascular networks. Increasing evidence supports structural and functional changes in retinal blood vessels as a biomarker for early identification of pathological conditions including neurodegenerative diseases, diabetes, renal disease and stroke.

A handful of studies have reported changes in the retinal vasculature in association with pregnancy complications including pre-eclampsia and reduced fetal growth. This raises the exciting potential for retinal imaging in pregnancy to be used for early detection of the mentioned pregnancy pathologies, allowing early preventative measures. The use of retinal imaging is attractive as it is non-invasive, quick to perform (