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Roberta McKean-Cowdin, Rohit Varma, Ge Wen, Kristina Tarczy-Hornoch, Susan Cotter, Mark S. Borchert, James M. Tielsch, David S. Friedman, Michael X. Repka, Joanne Katz; Risk Factors for Astigmatism in a Population-Based Study of Children. The Multiethnic Pediatric Eye Disease and the Baltimore Pediatric Eye Disease Studies. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3056.
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To evaluate risk factors for astigmatism in a population-based sample of preschool children conducted in Los Angeles, California and Baltimore, Maryland.
A cross-sectional study of children (6 - 72 months of age) participating in the Baltimore Eye Disease Study or the Multiethnic Pediatric Eye Disease Study was completed. Data were obtained by clinical examination or by in-person interview. Odds ratios and 95% confidence intervals (95%CI) were calculated to evaluate potential associations between demographics, clinical characteristics, or lifestyle factors and astigmatism.
Four factors were significantly associated with astigmatism including spherical refractive error, age, race/ethnicity and maternal smoking during pregnancy. Participants with myopia were 4.6 times as likely to have astigmatism (95%CI 3.56, 5.96) as those without refractive error while participants with hyperopia were 1.6 times as likely (95%CI 1.39, 1.94). Children 6 months to <12 months were approximately 3 times as likely to have astigmatism as children 5 to 6 years of age (95%CI 2.28, 3.73). Both Hispanic (OR=2.38) and African American (OR=1.47) children were more likely to have astigmatism than Non-Hispanic White children. Further, children whose mother’s smoked during pregnancy were 1.46 times (95% CI 1.14, 1.87) as likely to have astigmatism as children whose mothers did not smoke. The association with smoking was not significantly modified by age, gender, or race/ethnicity.
Astigmatism is a common refractive error for which the causes are largely unknown. We found age (<12 months), race/ethnicity, and spherical refractive error were all independently associated with astigmatism in preschool age children. Maternal smoking during pregnancy was the single modifiable risk factor associated with astigmatism. While the prevalence of smoking during pregnancy is typically low, this association may suggest etiologic pathways for future investigation.
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