Abstract
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 (STARS) study.
Methods: :
A total of 4164 Chinese Singaporean children were recruited, with a positive response rate of 72.3% (n = 3009 children). 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 (current smoking, past smoking history and smoking during pregnancy) being obtained.
Results: :
Spherical equivalent (SE) readings were obtained for 87.7% of the children of whom 52.1% were male (n=1375). The overall prevalence of myopia (SE -0.5 D or more) was 11.0%. 37.1% (n=1100) of the fathers interviewed gave a history of smoking. Among the mothers interviewed, 9.2% (n=272) gave a history of smoking, 6.6% had smoked during the child’s life and 2.2% had smoked during the pregnancy. A positive history of maternal smoking, smoking during the child’s life and smoking during pregnancy were associated with decreased odds of childhood myopia [Odds ratio (OR) of 0.53 (95% confidence interval (CI):0.32-0.88), p = 0.01), OR of 0.42 (CI:0.22-0.82, p=0.01), and OR of 0.44 (95% CI: 0.14-1.45, p = 0.18) respectively]. Paternal history of smoking was associated with decreased odds of childhood myopia [OR of 0.74 (CI:0.56-0.98), p = 0.04). These associations were obtained after controlling for confounders such as parental education levels and refractive errors.
Conclusions: :
Parental history of smoking, specifically maternal smoking during a child’s life, is associated with more hyperopic refraction readings in young children. The anti-myopic role of antimuscarinic agents such as atropine has already been previously shown. The association between smoking and childhood development deserves close attention due to the purported role of nicotinic receptors in ocular development.
Keywords: myopia • clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: prevalence/incidence