Balouch Malab S, Shahbaz Muhammad, Balouch Mohammad M, Balouch Mechale S, Abbasi Muneeb U
Neurorehabilitation Unit, Charing Cross Hospital London, Imperial College Healthcare Trusts, London, GBR.
Department of Optometry, Basheeran Umar Eye Hospital, Islamabad, PAK.
Cureus. 2022 Aug 23;14(8):e28311. doi: 10.7759/cureus.28311. eCollection 2022 Aug.
Objective The aim of this study was to determine the association between breastfeeding and the occurrence of refractive errors (REs) among children. Methodology This was a (retrospective) case-control study carried out between December 1, 2021, and March 30, 2022, at the Basheeran Umar Eye Hospital in Islamabad, Pakistan, and Sheikh Khalifa bin Zayed Al Nayhan Combined Military Hospital in Rawalakot in Kashmir, Pakistan. A total of 200 participants between the ages of five and 16 years (106 cases with REs and 94 controls without REs) were included in this study. After obtaining informed consent from the parent accompanying the participant, the parent was further interviewed to extract information regarding biodata, breastfeeding, and other parameters including parental myopia, the number of hours spent on outdoor activities, on gadgets, and doing near work; this data was entered into a questionnaire. The participant's visual acuity was then checked using the Snellen chart. Data were analyzed using SPSS Statistics version 20.0 (IBM Corp., Armonk, NY) and statistical tests such as multivariate regression analysis and chi-square were carried out and odds ratios (OR) were calculated. Results There were 74 (37%) females and 126 (63%) males, with 67.5% residing in urban localities and only 32.5% hailing from rural areas. Testing revealed no significant association between REs and area of residence (p=0.97) or the gender of the participant (p=0.74). Hypermetropia was the most common RE among our participants (59.4%). Breastfeeding was significantly associated with errors of refraction (OR: 27.852, 95% CI: 3.686-210.45, χ=21.680, p<0.001, degrees of freedom: 1), and we observed a lower risk of REs in children who had been breastfed. There was no association between REs and the number of hours spent outdoors per week or the number of hours spent using gadgets per week. However, there was a significant association between the development of REs and the duration of breastfeeding and the number of hours spent on near work. Conclusion This study demonstrates that breastfeeding plays a protective role in the prevention of REs. The type of breastfeeding also had a significant effect on the development of REs, i.e., children exclusively breastfed (regardless of the duration of breastfeeding) were less likely to develop errors of refraction in the future.
目的 本研究旨在确定母乳喂养与儿童屈光不正（REs）发生之间的关联。方法 这是一项（回顾性）病例对照研究，于2021年12月1日至2022年3月30日在巴基斯坦伊斯兰堡的巴希兰·奥马尔眼科医院以及巴基斯坦克什米尔拉瓦尔科特的谢赫·哈利法·本·扎耶德·阿勒纳哈扬联合军事医院开展。本研究共纳入200名年龄在5至16岁之间的参与者（106例患有屈光不正，94例未患屈光不正）。在获得陪同参与者的家长的知情同意后，进一步对家长进行访谈，以获取有关生物数据、母乳喂养以及其他参数的信息，包括父母近视情况、户外活动时长、使用电子产品时长以及从事近距离工作的时长；这些数据被录入问卷。然后使用斯内伦视力表检查参与者的视力。使用SPSS Statistics 20.0版本（IBM公司，纽约州阿蒙克）对数据进行分析，并进行多因素回归分析和卡方检验等统计测试，并计算比值比（OR）。结果 有74名（37%）女性和126名（63%）男性，67.5%居住在城市地区，仅有32.5%来自农村地区。测试显示屈光不正与居住地区（p = 0.97）或参与者性别（p = 0.74）之间无显著关联。远视是我们参与者中最常见的屈光不正类型（59.4%）。母乳喂养与屈光不正显著相关（OR：27.852，95%置信区间：3.686 - 210.45，χ = 21.680，p < 0.001，自由度：1），并且我们观察到母乳喂养的儿童患屈光不正的风险较低。屈光不正与每周户外活动时长或每周使用电子产品时长之间无关联。然而，屈光不正的发生与母乳喂养时长以及从事近距离工作的时长之间存在显著关联。结论 本研究表明母乳喂养在预防屈光不正方面发挥着保护作用。母乳喂养的类型对屈光不正的发生也有显著影响，即纯母乳喂养的儿童（无论母乳喂养时长）未来患屈光不正的可能性较小。
