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Comparative Study
. 2011 Oct;118(10):1974-81.
doi: 10.1016/j.ophtha.2011.06.031. Epub 2011 Aug 19.

Risk factors for astigmatism in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies

Roberta McKean-Cowdin  1 , Rohit Varma, Susan A Cotter, Kristina Tarczy-Hornoch, Mark S Borchert, Jesse H Lin, Ge Wen, Stanley P Azen, Mina Torres, James M Tielsch, David S Friedman, Michael X Repka, Joanne Katz, Josephine Ibironke, Lydia Giordano; Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study Groups
Affiliations
Comparative Study

Risk factors for astigmatism in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies

Roberta McKean-Cowdin et al. Ophthalmology. 2011 Oct.

Abstract

Objective: To evaluate risk factors for astigmatism in a population-based sample of preschool children.

Design: Population-based cross-sectional study.

Participants: Population-based samples of 9970 children ages 6 to 72 months from Los Angeles County, California, and Baltimore, Maryland.

Methods: A cross-sectional study of children participating in the Multiethnic Pediatric Eye Disease Study and the Baltimore Eye Disease Study was completed. Data were obtained by clinical examination or by in-person interview. Odds ratios and 95% confidence intervals (CI) were calculated to evaluate potential associations between clinical, behavioral, or demographic factors and astigmatism.

Main outcome measures: Odds ratios (ORs) for various risk factors associated with astigmatism.

Results: Participants with myopia (≤-1.0 diopters) were 4.6 times as likely to have astigmatism (95% CI, 3.56-5.96) than those without refractive error, whereas participants with hyperopia (≥+2.00 diopters) were 1.6 times as likely (95% CI, 1.39-1.94). Children 6 to <12 months of age were approximately 3 times as likely to have astigmatism than 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 as likely to have astigmatism than non-Hispanic white children. Furthermore, children whose mothers smoked during pregnancy were 1.46 times (95% CI, 1.14-1.87) as likely to have astigmatism than children whose mothers did not smoke.

Conclusions: In addition to infancy, Hispanic and African-American race/ethnicity and correctable/modifiable risk factors such as myopia, hyperopia, and maternal smoking during pregnancy are associated with a higher risk of having astigmatism. Although the prevalence of smoking during pregnancy is typically low, this association may suggest etiologic pathways for future investigation.

Financial disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.

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Figures

Figure 1
Figure 1
Participant flowchart highlighting those children who were included and excluded from the final analysis sample in preschool children from both the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) and the Baltimore Pediatric Eye Disease Study (BPEDS).
Figure 2
Figure 2
Locally weighted regression line illustrating the independent relationship between maternal, prenatal smoking in packs per month and the estimated prevalence of astigmatism in preschool children in the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study after controlling for other risk factors. The estimated prevalence of astigmatism was obtained using the stepwise logistic regression procedure.
Figure 3
Figure 3
Locally weighted regression line illustrating the independent relationship between spherical equivalent refractive error and the estimated prevalence of astigmatism in preschool children in the Multi-Ethnic Pediatric Eye Disease Study and the Baltimore Pediatric Eye Disease Study after controlling for other risk factors. The estimated prevalence of astigmatism was obtained using the stepwise logistic regression procedure.
See this image and copyright information in PMC

Comment in

  • Amblyopia refractive risk factors.
    Arnold RW, Neely DE, Donahue SP. Arnold RW, et al. Ophthalmology. 2012 Jun;119(6):1283; author reply 1283-4. doi: 10.1016/j.ophtha.2012.02.011. Ophthalmology. 2012. PMID: 22656894 No abstract available.

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