Department of Clinical and Evaluative Epidemiology, Trento Health Service, Trento, Italy -
Orthoptic Service, Department of Prevention, Trento Health Service, Trento, Italy.
Minerva Pediatr (Torino). 2023 Aug;75(4):468-475. doi: 10.23736/S2724-5276.18.05233-7. Epub 2018 Jul 2.
The aim of this study was to analyze the occurrence of specific maternal, obstetric or neonatal factors, by performing a comparison between children with refractive error, strabismus and/or amblyopia (cases) and unaffected children (controls) in the province of Trento (North-East Italy).
In 2012-2014, 14,346 children attending the second year of nursery school were assessed through the preschool orthoptic screening scheme (covering 91% of the preschool population). Record linkage was performed between the orthoptic screening database and birth records (birth confirmation certificate database) for the corresponding birth cohorts (2008-2010), to examine specific maternal factors (age, smoking, nationality/race), obstetric factors (type of delivery) and neonatal factors (gestational age, weight at birth, Apgar Score, congenital birth defects, hospitalization at birth). The correlations were investigated using univariate and multivariate analysis in accordance with the logistic regression method.
During orthoptic screening, 6.4% of children were found to have at least one refractive error, with astigmatism being the most common condition (5.1%). 1.9% of children were found to have strabismus and 1.8% amblyopia. Multivariate logistic regression analysis showed that the risk of developing a refractive error is associated with: maternal age ≥45 years, foreign nationality, vacuum-assisted delivery and neonatal weight <1500 grams. An excessive risk of strabismus was observed in children whose mother had smoked during pregnancy (adjusted OR=1.64).
Preschool orthoptic screening is a well-consolidated practice in the province of Trento, with adhesion values consistently over 90%. Studies of this type show the potential of record linkage between current information flows.
本研究旨在分析特定的产妇、产科或新生儿因素的发生情况，通过对屈光不正、斜视和/或弱视（病例）儿童与未受影响儿童（对照组）进行比较，在特伦蒂诺省（意大利东北部）进行分析。
2012-2014 年，通过学前视轴矫正筛查方案对 14346 名上幼儿园第二年的儿童进行评估（覆盖学前人口的 91%）。在相应的出生队列（2008-2010 年）中，对视轴矫正筛查数据库和出生记录（出生确认证书数据库）进行记录链接，以检查特定的产妇因素（年龄、吸烟、国籍/种族）、产科因素（分娩方式）和新生儿因素（胎龄、出生体重、阿普加评分、先天性出生缺陷、出生时住院）。使用单变量和多变量分析方法根据逻辑回归方法对相关性进行了调查。
在视轴矫正筛查过程中，发现 6.4%的儿童至少存在一种屈光不正，其中散光最常见（5.1%）。1.9%的儿童患有斜视，1.8%的儿童患有弱视。多变量逻辑回归分析显示，发生屈光不正的风险与：产妇年龄≥45 岁、外国国籍、真空辅助分娩和新生儿体重<1500 克有关。有吸烟史的母亲所生的儿童斜视风险过高（调整后的 OR=1.64）。
特伦蒂诺省的学前视轴矫正筛查是一种行之有效的做法，粘附率始终超过 90%。此类研究表明了当前信息流之间记录链接的潜力。
