Chapron Thibaut, Pierrat Véronique, Caputo Georges, Letouzey Mathilde, Kermorvant-Duchemin Elsa, Abdelmassih Youssef, Beaumont William, Barjol Amandine, Le Meur Guylene, Benhamou Valérie, Marchand-Martin Laetitia, Ancel Pierre-Yves, Torchin Héloïse
CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, Université Paris Cité, 75004 Paris, France.
Pediatric Ophthalmology Department, Rothschild Foundation Hospital, 25 rue Manin, CEDEX 19, 75940 Paris, France.
J Clin Med. 2022 Apr 11;11(8):2139. doi: 10.3390/jcm11082139.
We report the 51/2 year prevalence of visual and oculomotor impairments in preterm children born at 24−34 weeks’ gestation (WG) using the population-based cohort study EPIPAGE-2, set in France, 2011. The main outcomes were imputed prevalence of refractive errors (REs), strabismus, and binocular visual acuity (VA). Children were clinically assessed by specially trained pediatricians. The population was also analyzed in terms of cerebral palsy at 51/2 years (no CP, stage 1, stage 2, or stage 3−5) and retinopathy of prematurity in the neonatal period (no ROP, stage 1 or 2, or severe ROP). Among the 4441 children included, 2718 (weighted percentage 58.7%) were clinically assessed. REs were reported in 43.1% (95% confidence interval 37.6−48.4), 35.2% (32.7−37.6), and 28.4% (25.0−31.8) of children born at 24−26, 27−31, and 32−34 WG (p < 0.01), respectively; strabismus rates were 19.5% (14.6−24.4), 14.8% (12.9−16.7), and 8.3% (6.2−10.4) (p < 0.001), respectively. Moderate/severe visual deficiencies (VA < 3.2/10) were present in 1.7% (0.2−3.3) of children born at 24−26 WG, and in less than 1% in other groups. A suboptimal VA 5/10−6.3/10 was measured in 40.6% (35.3−45.8) of children born at 24−26 WG, 35.8% (33.5−38.1) at 27−31 WG, and 33.7% (30.4−37.0) at 32−34 WG. CP and ROP were associated with strabismus and RE. The association between CP and VA was strong, while it was not observed for ROP. In this large cohort of preterm-born children, we found a high prevalence of RE and strabismus regardless of WG, supporting the need for specific attention in this population. High prevalence of suboptimal VA could be challenging for these children at the age of reading and writing acquisition.
我们利用2011年在法国开展的基于人群的队列研究EPIPAGE-2，报告了妊娠24 - 34周出生的早产儿5.5岁时视力和眼球运动障碍的患病率。主要结局指标为屈光不正（REs）、斜视和双眼视力（VA）的估算患病率。由经过专门培训的儿科医生对儿童进行临床评估。还根据5.5岁时的脑瘫情况（无脑瘫、1期、2期或3 - 5期）和新生儿期的早产儿视网膜病变情况（无ROP、1或2期、或重度ROP）对人群进行分析。在纳入的4441名儿童中，2718名（加权百分比58.7%）接受了临床评估。出生于24 - 26周、27 - 31周和32 - 34周妊娠的儿童中，分别有43.1%（95%置信区间37.6 - 48.4）、35.2%（32.7 - 37.6）和28.4%（25.0 - 31.8）报告有屈光不正（p < 0.01）；斜视发生率分别为19.5%（14.6 - 24.4）、14.8%（12.9 - 16.7）和8.3%（6.2 - 10.4）（p < 0.001）。出生于24 - 26周妊娠的儿童中，1.7%（0.2 - 3.3）存在中度/重度视力缺陷（VA < 3.2/10），其他组低于1%。出生于24 - 26周妊娠的儿童中，40.6%（35.3 - 45.8）测量的视力为5/10 - 6.3/10，27 - 憨31周妊娠的儿童中为35.8%（33.5 - 38.1），32 - 34周妊娠的儿童中为33.7%（30.4 - 37.0）。脑瘫和ROP与斜视及屈光不正相关。脑瘫与视力之间的关联较强，而ROP与视力之间未观察到关联。在这个大型早产儿队列中，我们发现无论妊娠周数如何，屈光不正和斜视的患病率都很高，这支持了对该人群给予特别关注的必要性。视力欠佳的高患病率可能对这些儿童在读写能力获得的年龄阶段构成挑战。
