Minassian D C, Mehra V, Reidy A
Department of Epidemiology and International Eye Health, Institute of Ophthalmology, University College London, UK.
Br J Ophthalmol. 2002 May;86(5):548-50. doi: 10.1136/bjo.86.5.548.
BACKGROUND/AIMS: Observations in central India, over a period of more than a decade, suggested that the frequency of sight restoring cataract surgery was substantially higher in women of childbearing age compared to men of the same age. Formal surveys in the subcontinent of India have confirmed a higher prevalence of cataract in women. The present study was conducted to explore possible effects of childbearing and associated adverse factors on cataract risk.
A case-control study design was used. Cases were mothers aged 35-45 with bilateral "senile" cataract. Controls were mothers of the same age but with clear lenses, attending the hospital services with other, mostly minor, complaints.
A significant association was found between childbearing and risk of sight impairing cataract in mothers. Having more than three babies doubled the risk (adjusted odds ratio 2.0, p=0.012), and the risk increased by an estimated 20% for each additional birth. The birth effect was independent of age, socioeconomic status (occupation and income level), body mass index, and multiple episodes of severe dehydration, all regarded as putative risk factors for cataract.
Having more than three babies may substantially increase the risk of sight impairing cataract in mothers of childbearing age in central India. The findings open new research challenges to identify cataract risk factors to which mothers may be exposed during pregnancy and childbirth, particularly under poor socioeconomic conditions.
背景/目的:在印度中部超过十年的观察表明,与同年龄段男性相比,育龄期女性视力恢复性白内障手术的发生率显著更高。印度次大陆的正式调查证实女性白内障患病率更高。本研究旨在探讨生育及相关不利因素对白内障风险的可能影响。
采用病例对照研究设计。病例为年龄在35至45岁之间患有双侧“老年性”白内障的母亲。对照为年龄相同但晶状体清晰、因其他(大多为轻微)疾病前来医院就诊的母亲。
发现生育与母亲视力损害性白内障风险之间存在显著关联。生育三个以上孩子使风险增加一倍(调整后的优势比为2.0,p = 0.012),且每多生育一次风险估计增加20%。生育的影响独立于年龄、社会经济地位(职业和收入水平)、体重指数以及多次严重脱水,所有这些因素均被视为白内障的假定风险因素。
生育三个以上孩子可能会大幅增加印度中部育龄期母亲视力损害性白内障的风险。这些发现为识别母亲在怀孕和分娩期间可能接触到的白内障风险因素带来了新的研究挑战,尤其是在社会经济条件较差的情况下。