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- Title
Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring.
- Authors
Zhu, Hui; You, Xue; Jing, Yu; Chen, Yiyuan; Jiang, Yangqian; Lin, Yuan; Jiang, Tao; Qin, Rui; Lv, Hong; Lu, Qun; Liu, Cong; Xu, Xin; Liu, Yuxin; Sun, Tianyu; Jiang, Mengting; Xu, Bo; Han, Xiumei; Chen, Jiaping; Jiang, Yue; Liu, Xiaoyu
- Abstract
Key Points: Question: Is there an association between maternal hypertensive disorder of pregnancy (HDP) and childhood strabismus in offspring? Findings: In this cohort study that included 3117 children, offspring born to mothers with HDP had an 82% higher overall risk of strabismus at 3 years of age, and offspring with maternal preeclampsia and poorly controlled blood pressure had the highest risk. Meaning: These findings suggest that early screening of strabismus might be recommended for offspring born to mothers with HDP, especially those with maternal preeclampsia or poorly controlled blood pressure. This cohort study investigates the association of maternal hypertensive disorder in pregnancy with overall and type-specific strabismus in offspring at 3 years of age. Importance: Maternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear. Objective: To examine the association of maternal HDP with overall and type-specific strabismus in offspring. Design, Setting, and Participants: 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. Exposure: 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). Main Outcomes and Measures: 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. Results: 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. Conclusions and Relevance: 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.
- Subjects
CHINA; POISSON distribution; MATERNAL health services; RESEARCH funding; GESTATIONAL diabetes; HYPERTENSION; STRABISMUS; DESCRIPTIVE statistics; RELATIVE medical risk; HYPERTENSION in pregnancy; LONGITUDINAL method; PREECLAMPSIA; GESTATIONAL age; BLOOD pressure; PREGNANCY complications; CONFIDENCE intervals; CHILDREN
- Publication
JAMA Network Open, 2024, Vol 7, Issue 7, pe2423946
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.23946