Associations of preconception retinal microvasculature with lipid profiles from mid-pregnancy to three months postpartum

We examined associations between preconception retinal microvasculature and maternal dyslipidemia at mid-pregnancy and three months postpartum in 366 women (mean age 29.9 years). Preconception retinal vascular morphology assessed arteriolar and venular caliber, fractal dimension, and branching angle. Lipids were measured at 24–28 weeks’ gestation and at three months postpartum. We analyzed relationships with each time point separately, overall change, and classification by clinical cut-offs for suboptimal lipid status using 187 complete data. Wider venular caliber, higher arteriolar fractal dimension, and larger arteriolar branching angle were associated with adverse lipid changes; other retinal parameters showed no association. Notably, each standard deviation increase in arteriolar branching angle was linked to higher odds of persistently suboptimal total cholesterol (OR 2.23, 95% CI 1.25, 4.00) and LDL cholesterol (OR 3.20, 95% CI 1.46, 6.85) from mid-pregnancy to three months postpartum. Preconception retinal imaging may add value to antenatal and postpartum maternal dyslipidemia risk classifications and future cardiovascular disease.