Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring
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Published:2024-07-22
Issue:7
Volume:7
Page:e2423946
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ISSN:2574-3805
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Container-title:JAMA Network Open
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language:en
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Short-container-title:JAMA Netw Open
Author:
Zhu Hui123, You Xue23, Jing Yu1, Chen Yiyuan23, Jiang Yangqian234, Lin Yuan2345, Jiang Tao236, Qin Rui23, Lv Hong235, Lu Qun24, Liu Cong23, Xu Xin234, Liu Yuxin23, Sun Tianyu23, Jiang Mengting23, Xu Bo23, Han Xiumei23, Chen Jiaping23, Jiang Yue23, Liu Xiaoyu23, Zhou Kun23, Jin Guangfu235, Ma Hongxia235, Hu Zhibin235, Liu Hu1, Du Jiangbo235, Shen Hongbing7, Xia Yankai7, Li Jiong7, Lu Chuncheng7, Zhao Yang7, Wu Wei7, Chen Minjian7, Geng Shanshan7, Ding Ye7, Huang Lei7, Tao Shiyao7, Dou Yuanyan7, Lei Shuifang7, Ke Kang7, Zhang Yanjie7, Xu Yiqun7, Wang Jinghan7, Zhu Xianxian7, Xue Huixin7, Gan Ming7, Xiao Shuxin7, Wang Weiting7, Pi Di7, Wang Chang7, Zhang Haowen7, Yang Bo7, Jin Yufan7, Zhang Xiao7, Xiong Yongbin7, Zou Xin7, Yong Zheng7, Wu Shuting7, Qu Yue7, Wang Qin7, Chen Jie7, Liao Ganchong7, Pang Liya7, Huang Dan7, Fu Zhujun7, Wang Zijin7, Wang Yue7, Li Rui7, Tong Haohai7, Han Shu7, Zhao Xiaoyan7, Shen Shiya7, Wang Yun7, Yan Wen7, Li Xiaoxiao7, Zhao Andi7, Chen Danni7, Liu Lei7, Guo Wei7, Qian Yingxiao7, Hua Lei7, Yan Qi7, Zuo Xiaoxia7, Zhang Tong7, Ni Ziyi7, Jing Yu7, Zhou Tiantian7, Zhu Xiaoqi7, Zhou Chenyu7, Zhang Yuting7, Shi Yunfan7, Feng Yuhong7, Zhang Chuxuan7, Chi Haodong7, Sun Fanbo7, Cui Jian7, Gao Yan7, Yao Xinyuan7, Li Meng7, Si Jiahao7, Xu Shasha7, Chen Xi7, Zhang Jiyu7, Zheng Xinyu7, Cao Yelongzi7, Shao Xiaodong7, Liu Shuning7, Chen Yuxi7, Shu Qin7, Li Shiding7, Dang Jingsong7, Zhang Tao7, Ding Ranran7, Wu Yuemin7, Wang Liyuan7, Zhao Ningjing7, Yang Jiajia7, Zhao Shuoyang7, Qian Yichao7, Lu Yao7, Zhu Yue7, Ma Fanfei7, Zhang Changqin7, Xu Yuxiao7, Zhu Yan7, Dong Weiyi7, Dong Mengqi7, Li Zhitong7, Sun Jing7, Yi Yuxiang7, Fu Hongxue7, Dou Jie7, Gao Wanting7, Li Zhuorong7, Sun Leyan7, Tang Lan7, Xu Xinyan7, Yang Jingwen7, Xue Ping7, Huang Shengxiang7, Xia Yidan7, Gu Sirui7, Chen Yaxin7, Zhang Yizheng7, Chen Qi7, Wu Ruize7, Shi Anqi7, Jiang Yujie7, Xu Rui7, Mei Linting7, Zhu Xuexian7, Wang Yiting7, Liang Xianyue7, Xu Jing7, Zhang Zheng7, Xu Chengfei7, Liu Jin7, Wang Yucao7, Liang Jinghan7, Li Jiaxu7, You Junyi7, Lin Zhiying7, Zhou Wenjie7, Yin Zihan7, Sun Cheng7, Zuo Difei7, Zhu Ruini7, Deng Qikun7, Shi Yujiao7, Wang Yujie7, Wang Zhen7, Fan Xiaoyu7, Li Xinying7,
Affiliation:
1. Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China 2. State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China 3. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China 4. Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China 5. State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China 6. Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China 7. for the China National Birth Cohort Study Group
Abstract
ImportanceMaternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear.ObjectiveTo examine the association of maternal HDP with overall and type-specific strabismus in offspring.Design, Setting, and ParticipantsIn 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.ExposureMaternal 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).Main Outcomes and MeasuresThe 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.ResultsAmong 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.Conclusions and RelevanceThese 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.
Publisher
American Medical Association (AMA)
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