■母亲妊娠期高血压疾病(HDP)可能会影响后代的眼部健康;然而,其与斜视的关联尚不清楚。
■研究母体HDP与后代整体和类型特异性斜视的关系。
■在江苏出生队列研究中,中国的一项基于人群的研究,孕妇招募时间为2014年4月24日至2018年11月30日.共有6195个后代有母体HDP诊断信息,其中3078人由于没有眼对准信息或患有除斜视或屈光不正以外的眼部疾病而被排除。后代在3岁时接受了眼部检查,2022年5月21日完成。数据从2022年5月28日至2023年12月15日进行了分析。
■产妇HDP,分为高血压和先兆子痫或血压(BP)控制良好(收缩压,<130;舒张压血压,<80mmHg)且控制不佳(收缩压,≥130;舒张压血压,≥80mmHg)。
■主要结果是后代斜视的发生率。使用泊松广义线性混合模型来估计母体HDP与斜视之间的关联。
■在纳入的3117名儿童中(平均[SD]年龄,36.30[0.74]个月;1629名男孩[52.3%]),143例(4.6%)暴露于母体HDP,368例(11.8%)斜视。暴露于母体HDP的后代总体斜视风险增加82%(相对风险[RR],1.82[95%CI,1.21-2.74]),外隐症风险增加82%(RR,1.82[95%CI,1.11-3.00]),间歇性外斜视的风险增加136%(RR,与未暴露的后代相比,2.36[95%CI,1.13-4.93])。当考虑母体HDP的类型时,对于暴露于先兆子痫的后代,所有斜视的风险都很高(RR,与未暴露的后代相比,2.38[95%CI,1.39-4.09])。在考虑孕妇HDP的血压控制水平时,对于患有HDP和血压控制不佳的母亲所生的后代,所有斜视的风险都很高(RR,与未暴露的后代相比,2.07[95%CI,1.32-3.24])。
■这些研究结果表明,母体HDP与后代斜视的风险增加有关。可能建议对患有母体HDP的后代进行斜视的早期筛查。需要进一步探索HDP与斜视之间关联的潜在机制。
UNASSIGNED: Maternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear.
UNASSIGNED: To examine the association of maternal HDP with overall and type-specific strabismus in offspring.
UNASSIGNED: In the Jiangsu Birth Cohort study, a population-based study in
China, pregnant women were recruited from April 24, 2014, to November 30, 2018. A total of 6195 offspring had maternal HDP diagnosis information, of whom 3078 were excluded due to having no information on ocular alignment or due to having ocular diseases other than strabismus or refractive error. Offspring underwent ocular examinations at 3 years of age, completed May 21, 2022. Data were analyzed from May 28, 2022, through December 15, 2023.
UNASSIGNED: Maternal HDP, categorized into hypertension and preeclampsia or with blood pressure (BP) well controlled (systolic BP, <130; diastolic BP, <80 mm Hg) and poorly controlled (systolic BP, ≥130; diastolic BP, ≥80 mm Hg).
UNASSIGNED: The primary outcome was the incidence of strabismus in offspring. Poisson generalized linear mixed models were used to estimate the association between maternal HDP and strabismus.
UNASSIGNED: Among the included 3117 children (mean [SD] age, 36.30 [0.74] months; 1629 boys [52.3%]), 143 (4.6%) were exposed to maternal HDP and 368 (11.8%) had strabismus. Offspring exposed to maternal HDP had an 82% increased risk of overall strabismus (relative risk [RR], 1.82 [95% CI, 1.21-2.74]), an 82% increased risk of exophoria (RR, 1.82 [95% CI, 1.11-3.00]), and a 136% increased risk of intermittent exotropia (RR, 2.36 [95% CI, 1.13-4.93]) compared with unexposed offspring. When considering the type of maternal HDP, the risk for all strabismus was high for offspring exposed to preeclampsia (RR, 2.38 [95% CI, 1.39-4.09]) compared with unexposed offspring. When considering the BP control level of maternal HDP, the risk for all strabismus was high for offspring born to mothers with HDP and poorly controlled BP (RR, 2.07 [95% CI, 1.32-3.24]) compared with unexposed offspring.
UNASSIGNED: These findings suggest that maternal HDP is associated with an increased risk of offspring strabismus. Early screening of strabismus might be recommended for offspring with maternal HDP. Further exploration of the underlying mechanism of the association between HDP and strabismus is warranted.