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Strabismus in children of birth weight less than 1701 g
Anna R O'Connor1, Terence J Stephenson, Ann Johnson
1Division of Child Health, University of Nottingham, England. anna.oc@prodigy.net
Insights
Children born with low birth weight have a significantly higher risk of developing strabismus. Key risk factors include retinopathy of prematurity, low birth weight, and cerebral palsy.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Strabismus is a common ocular misalignment.
- Preterm birth and low birth weight are known risk factors for various developmental issues.
- Long-term outcomes for extremely low birth weight infants require continued investigation.
Purpose of the Study:
- To determine the incidence and risk factors for strabismus in children born preterm.
- To prospectively study infants with birth weight less than 1701 g.
- To assess strabismus prevalence at 10 to 12 years of age.
Main Methods:
- A prospective cohort study of 572 low-birth-weight infants (birth weight <1701 g) was conducted.
- A control group of 169 full-term schoolchildren was recruited.
- Follow-up examinations occurred at 10 to 12 years of age.
Main Results:
- The prevalence of strabismus was significantly higher in the low-birth-weight cohort (20.1%) compared to the school cohort (3.0%).
- Retinopathy of prematurity, lower birth weight, cerebral palsy, anisometropia, and refractive error were independently associated with strabismus.
- An increased occurrence of exotropia was noted in the low-birth-weight group.
Conclusions:
- This study confirms a substantially increased prevalence of strabismus in individuals born with low birth weight.
- Detailed information on specific risk factors and types of strabismus in this population was provided.
- Early identification and management of strabismus in preterm infants are crucial.
Objective:
To prospectively study infants of birth weight less than 1701 g in the East Midlands of England in the mid 1980s at 10 to 12 years of age to determine the incidence and risk factors for strabismus in children born preterm.
Methods:
Low-birth-weight children (n = 572) who had been examined during the neonatal period were invited for a follow-up visit at age 10 to 12 years; 169 eleven-year-old schoolchildren born at full term were also recruited (the school cohort).
Results:
Of the original 572 children, 293 consented to further examination. There was no significant difference between children who were examined and those who were not in terms of birth weight, gestational age, retinopathy of prematurity, and cranial ultrasound abnormalities. Compared with the school cohort (n = 5 [3.0%]; 95% confidence interval, 1.0%-9.1%), the low-birth-weight cohort had a significant increase in the prevalence of strabismus (n = 59 [20.1%]; 95% confidence interval, 15.9%-25.0%; P<.001). Compared with published data, there was a relative increase in the occurrence of exotropia in the low-birth-weight study cohort. Multivariate analysis, by backward logistic regression, indicated that retinopathy of prematurity, birth weight, cerebral palsy, anisometropia, and refractive error were all independently associated with strabismus (P<.05).
Conclusions:
The results of this study confirm the increased prevalence of strabismus in a low-birth-weight population. This study also provides more detailed information on risk factors and strabismus types.