Association between congenital nasolacrimal duct obstruction and mode of delivery at birth
- PMID: 30243932
- DOI: 10.1016/j.jaapos.2018.05.016
Association between congenital nasolacrimal duct obstruction and mode of delivery at birth
Abstract
Purpose: To investigate the association between mode of delivery, incidence of congenital nasolacrimal duct obstruction (CNLDO), and treatment outcomes.
Methods: The medical records of children diagnosed with CNLDO at a tertiary referral center between 2012 and 2017 were analyzed retrospectively. Patient demographics, pregnancy and birth history, clinical characteristics of CNLDO, and treatment outcomes were compared in patients delivered via Cesarean section (CS) versus vaginal delivery (VD). The rates of CS, as well as full-term and premature births, were also compared to Miami-Dade County normative values to eliminate the confounding effects of prematurity.
Results: A total of 104 patients were included. A significantly higher percentage of patients with CNLDO (61%) were delivered via CS (P < 0.0001). Among full-term babies, there was 55% greater risk (OR = 1.55; 95% CI, 0.98-2.43; P = 0.067) of CNLDO for CS birth compared to all other babies. Among preterm babies, there were no significantly greater odds of CNLDO for CS compared to VD births (P = 0.575). CNLDO did not resolve spontaneously in 50 patients, including 37 CS (74%) and 13 VD (26%) patients (P = 0.007). Among those patients who failed first-line probing, 86.2% were born via CS, whereas 13.8% were born via VD (P = 0.0009).
Conclusions: CS is a risk factor for CNLDO, independent of gestational age. Children born via CS also tend to have a more complicated clinical course requiring additional surgical interventions.
Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Comment in
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Association between congenital nasolacrimal duct obstruction and mode of delivery at birth.J AAPOS. 2019 Apr;23(2):125. doi: 10.1016/j.jaapos.2019.01.002. Epub 2019 Feb 5. J AAPOS. 2019. PMID: 30731127 No abstract available.
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Reply.J AAPOS. 2019 Apr;23(2):125-126. doi: 10.1016/j.jaapos.2019.02.002. Epub 2019 Mar 11. J AAPOS. 2019. PMID: 30872021 No abstract available.
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