Early childhood eye diseases and perinatal risk factors: potential of record linkage between current information
Riccardo Pertile1, Cristina Trettel2, Lucia Bombarda3
1Department of Clinical and Evaluative Epidemiology, Trento Health Service, Trento, Italy - riccardo.pertile@apss.tn.it.
Insights
Maternal age over 45, foreign nationality, vacuum-assisted delivery, and low birth weight increase refractive error risk. Maternal smoking during pregnancy is linked to a higher risk of strabismus in children.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Childhood visual impairments like refractive error, strabismus, and amblyopia pose significant health challenges.
- Identifying associated maternal, obstetric, and neonatal factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To investigate the relationship between maternal, obstetric, and neonatal factors and the occurrence of refractive errors, strabismus, and amblyopia in preschool children.
- To compare risk factors in children diagnosed with these conditions against a control group of unaffected children.
Main Methods:
- Utilized data from a 2012-2014 preschool orthoptic screening of 14,346 children in Trento, Italy.
- Linked screening data with birth records (2008-2010 cohorts) to analyze maternal age, smoking, nationality, delivery type, gestational age, birth weight, Apgar score, and congenital defects.
- Employed univariate and multivariate logistic regression analysis to determine correlations.
Main Results:
- Refractive errors were detected in 6.4% of children (astigmatism 5.1%), strabismus in 1.9%, and amblyopia in 1.8%.
- Risk factors for refractive error included maternal age ≥45, foreign nationality, vacuum-assisted delivery, and neonatal weight <1500g.
- Maternal smoking during pregnancy was associated with an increased risk of strabismus (adjusted OR=1.64).
Conclusions:
- Preschool orthoptic screening in Trento is highly effective, with over 90% participation.
- Record linkage between health information systems offers valuable insights into child health risk factors.
- Findings highlight specific risk factors that can inform targeted screening and prevention programs for childhood visual impairments.
Background:
The aim of this study was to analyze the occurrence of specific maternal, obstetric or neonatal factors, by performing a comparison between children with refractive error, strabismus and/or amblyopia (cases) and unaffected children (controls) in the province of Trento (North-East Italy).
Methods:
In 2012-2014, 14,346 children attending the second year of nursery school were assessed through the preschool orthoptic screening scheme (covering 91% of the preschool population). Record linkage was performed between the orthoptic screening database and birth records (birth confirmation certificate database) for the corresponding birth cohorts (2008-2010), to examine specific maternal factors (age, smoking, nationality/race), obstetric factors (type of delivery) and neonatal factors (gestational age, weight at birth, Apgar Score, congenital birth defects, hospitalization at birth). The correlations were investigated using univariate and multivariate analysis in accordance with the logistic regression method.
Results:
During orthoptic screening, 6.4% of children were found to have at least one refractive error, with astigmatism being the most common condition (5.1%). 1.9% of children were found to have strabismus and 1.8% amblyopia. Multivariate logistic regression analysis showed that the risk of developing a refractive error is associated with: maternal age ≥45 years, foreign nationality, vacuum-assisted delivery and neonatal weight <1500 grams. An excessive risk of strabismus was observed in children whose mother had smoked during pregnancy (adjusted OR=1.64).
Conclusions:
Preschool orthoptic screening is a well-consolidated practice in the province of Trento, with adhesion values consistently over 90%. Studies of this type show the potential of record linkage between current information flows.
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