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Risk factors for esotropia and exotropia
E Chew1, N A Remaley, A Tamboli
1National Eye Institute, National Institutes of Health, Bethesda, Md.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|October 1, 1994
Summary
Low birth weight and maternal smoking during pregnancy are key risk factors for childhood strabismus (esotropia and exotropia). Increased maternal age also elevates the risk of esotropia in children.
Area of Science:
- Ophthalmology
- Pediatric Health
- Epidemiology
Background:
- Strabismus, a common childhood eye misalignment, includes esotropia (inward turning) and exotropia (outward turning).
- Identifying risk factors is crucial for early intervention and prevention strategies.
Purpose of the Study:
- To determine risk factors for esotropia and exotropia in a large cohort of children followed from gestation to age 7.
- To analyze the association of various maternal, socioeconomic, perinatal, and neonatal factors with strabismus development.
Main Methods:
- Prospective cohort study involving 39,227 children enrolled from 1959-1965.
- Data collected via maternal interviews and medical examinations at birth, 4, 8 months, 1 year, and 7 years.
- Multivariable logistic regression used to identify significant risk factors.
Main Results:
- Esotropia occurred in 3.0% and exotropia in 1.2% of children.
- Low birth weight (<1500g) significantly increased odds for esotropia (OR 3.26) and exotropia (OR 4.01).
- Maternal smoking (>2 packs/day) increased odds for esotropia (OR 1.83) and exotropia (OR 2.32). Increased maternal age also correlated with higher esotropia risk.
Conclusions:
- Maternal cigarette smoking and low birth weight are independent, significant risk factors for both esotropia and exotropia.
- Esotropia risk increases with maternal age, particularly for mothers aged 30-34.
- Race influenced esotropia prevalence (higher in whites) but not exotropia.