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Parental smoking and childhood refractive error: the STARS study
J V Iyer1, W C J Low, M Dirani
1Singapore National Eye Center, 11 Third Hospital Avenue, Singapore 168751, Singapore. jayant.venkatramani@snec.com.sg
Insights
Parental smoking, including maternal and paternal history, was inversely associated with childhood myopia in Singaporean children. This suggests a potential protective effect, warranting further research into ocular development and myopia prevention strategies.
Area of Science:
- Ophthalmology and Vision Science
- Pediatric Health
- Public Health
Background:
- Childhood myopia is a growing public health concern with complex etiological factors.
- Understanding environmental influences, such as parental lifestyle, is crucial for identifying risk and protective factors.
- The STrabismus, Amblyopia, and Refractive errors in Singaporean children (STRAB) study provides a valuable cohort for investigating early-life influences on vision.
Purpose of the Study:
- To investigate the association between parental smoking and the prevalence of refractive errors, specifically myopia, in young Singaporean Chinese children.
- To determine if maternal and paternal smoking habits during pregnancy and after birth influence the risk of myopia development.
- To explore potential mechanisms underlying the observed associations, considering nicotinic acetylcholine receptor involvement.
Main Methods:
- A cohort of 3009 children aged 6-72 months from the STRAB study underwent cycloplegic refraction assessment.
- Parental smoking history (maternal and paternal) was collected via interviewer-administered questionnaires.
- Statistical analysis, including odds ratios (OR), was used to assess the relationship between parental smoking and childhood myopia prevalence.
Main Results:
- The prevalence of myopia (spherical equivalent ≤ -0.5 D) was 11.0% among the participating children.
- Maternal smoking during pregnancy (OR 0.30) and paternal smoking (OR 0.72) were significantly associated with decreased odds of childhood myopia.
- Maternal history of ever smoking and smoking during the child's life also showed a protective association with myopia.
Conclusions:
- Parental smoking appears to have an inverse association with childhood myopia, suggesting a potential protective effect.
- Further research is recommended to elucidate the role of nicotinic acetylcholine receptor pharmacology in ocular development.
- These findings may inform the development of novel therapeutic strategies for myopia prevention.
Purpose:
To assess the relationship between parental smoking and childhood refractive errors in Singapore Chinese children aged 6-72 months recruited through the STrabismus, Amblyopia, and Refractive errors in Singaporean children study.
Methods:
A total of 4164 children were recruited, with a positive response rate of 72.3% (n=3009). Cycloplegic refraction measurements were obtained from all children by trained eye professionals. Parents underwent an interviewer-administered questionnaire with information on demographics, lifestyle, and parental smoking history being obtained.
Results:
Spherical equivalent readings were obtained for 87.7% of the children. In all, 52.1% were male (n=1375). The overall prevalence of myopia (at least -0.5 D) was 11.0%. Overall, 37.1% of the fathers interviewed gave a history of smoking. Among the mothers interviewed, 9.2% gave a history of smoking, 6.6% had smoked during the child's life, and 2.2% had smoked during the pregnancy. Maternal history of ever smoking, smoking during child's life, and smoking during pregnancy were associated with decreased odds ratio (OR) of childhood myopia (OR 0.50 (P=0.01), OR 0.39 (P=0.01), and OR 0.3 (P=0.14), respectively). Paternal history of smoking was associated with decreased OR of childhood myopia (OR of 0.72 (P=0.02)).
Conclusion:
In light of this finding of an inverse association between parental smoking and childhood myopia, further studies are suggested to better understand the role of nicotinic acetylcholine receptor pharmacology in ocular development. This may pave the way for the development of targeted treatment strategies for prevention of myopia.
