9月龄婴儿屈光状态及其胎婴儿期影响因素

doi:10.3760/cma.j.cn115909-20210809-00309

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摘要目的：研究9月龄婴儿屈光状态及其胎婴儿期的影响因素，为屈光异常的早期预防提供科学依据。方法：基于监测数据的回顾性研究。根据上海市闵行区妇幼保健院2012年至2019年积累的屈光筛查记录，纳入16 746名9月龄婴儿作为研究对象，通过儿保体检记录和问卷调查资料采集9月龄前的影响因素，对屈光状态进行描述。采用卡方检验和多因素回归模型分析胎婴儿期因素与各类可能屈光异常的关联。结果：9月龄婴儿球镜度P5~P95为+0.50~+3.00 D，柱镜度P5为-2.50 D。屈光可能偏近视、屈光可能偏远视、可能散光及可能屈光参差的检出率分别为13.46%、11.13%、25.58%和8.29%。在控制性别和遗传因素后，冬季出生、经常看电子产品与较高的屈光可能偏近视发生风险有关（调整 OR=1.35、1.55）；夏季及秋季出生、早产、9月龄体格百分位数≥P80与较高的屈光可能偏远视发生风险有关（调整OR=1.67、1.62、1.80、1.22）；夏季出生、9月龄体格百分位数≥P80、9月龄采用人工喂养与较高的可能散光发生风险有关（调整OR=1.92、1.42、1.19）。每日户外活动时长>0.5 h与较低的各类可能屈光异常发生风险有关（调整OR=0.71~0.80）。结论：9月龄婴儿各种可能屈光问题的检出率为8%～25%，散光比较突出。具有早产、父母屈光异常、较大体格等高危因素的婴幼儿应作为屈光筛查和随访的重点。

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关键词 ：婴儿, 屈光, 眼, 儿童保健服务

Abstract：Objective: To explore the refractive status along with relevant factors during the fetal and infancy period in 9-month-old infants, and to provide evidence for early prevention and intervention of refractive errors. Methods: This study analyzed refractive screening data accumulated by the Minhang District Maternal and Child Health Care Institution, Shanghai, from 2012 to 2019. In all, 16 746 infants aged 9 months were included in the description of refractive status. Relevant factors before 9 months of age were collected by child health examination records and questionnaire survey data. Chi-square tests and multivariate regression models were used to analyze the association of factors during the fetal and infancy periods in 9-month-old infants with suspicious refractive errors. Results: The P5-P95 of the refractive sphere for infants aged 9 months was +0.50 D-+3.00 D, and the P5 of the refractive cylinder for infants aged 9 months was -2.50 D. Detection rates of suspected myopia, hyperopia, astigmatism, and anisometropia were 13.46%, 11.13%, 25.58%, 8.29%, respectively. Birth during the winter and frequent contact with electronic devices increased the risk of suspected myopia (adjusted OR were 1.35, 1.55 respectively). Birth during the summer or autumn, prematurity and a physique greater than the P80 quantile at 9 months of age increased the risk of suspected hyperopia (adjusted OR were 1.67, 1.62, 1.80, 1.22 respectively). Birth during the summer, a physique greater than the P80 quantile and artificial feeding at 9 months of age increased the risk of suspected astigmatism (adjusted OR were 1.92, 1.42, 1.19, respectively). Outdoor activities of more than 0.5 h per day decreased the risk of suspected refractive errors (adjusted OR=0.711- 0.803). Conclusion: Detection rates of suspected refractive errors in infants aged 9 months are between 8% and 25%, among which astigmatism is most significant. Infants with high-risk factors such as prematurity, parents with refractive errors and large physique should be the focus of refractive screening and follow-up. Key words: infants; refraction; eye; child health service

Key words： nfants refraction eye child health service

收稿日期: 2021-08-09

PACS:

基金资助:上海市第五轮加强公共卫生体系建设三年行动计划（2020—2022年）重点学科建设项目 “儿少卫生与妇幼卫生学”（GWV-10.1-XK08）；闵行区公共卫生品牌科室项目（MGWKS02）；闵行区自然科学基金（2020MHZ008）

通讯作者: 史慧静（ORCID: 0000-0003-2403-550X），Email：hjshi@fudan.edu.cn；黄俊（ORCID: 0000-0003-1249-2439），Email：huangjunyian@sina.com

引用本文:

王昱杰, 薛丽丽, 张越, 等.. 9月龄婴儿屈光状态及其胎婴儿期影响因素[J]. 中华眼视光学与视觉科学杂志, 2022, 24(4): 270-277. Yujie Wang1, Lili Xue2, Yue Zhang2, et al. Refractive Status and Its Influencing Factors in Infants during the First 9 Months. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(4): 270-277. DOI: 10.3760/cma.j.cn115909-20210809-00309

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210809-00309 或 https://www.cjoovs.com/CN/Y2022/V24/I4/270

[1]	Pai AS, Rose KA, Leone JF, et al. Amblyopia prevalence and risk factors in Australian preschool children. Ophthalmology, 2012, 119(1): 138-144. DOI: 10.1016/j.ophtha.2011.06.024.
[2]	Cotter SA, Varma R, Tarczy-Hornoch K, et al. Risk factors associated with childhood strabismus: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies. Ophthalmology, 2011, 118(11): 2251-2261. DOI: 10.1016/ j.ophtha.2011.06.032.
[3]	Pai AS, Wang JJ, Samarawickrama C, et al. Prevalence and risk factors for visual impairment in preschool children the sydney paediatric eye disease study. Ophthalmology, 2011, 118(8): 1495-1500. DOI: 10.1016/j.ophtha.2011.01.027.
[4]	Davidson S, Quinn GE. The impact of pediatric vision disorders in adulthood. Pediatrics, 2011, 127(2): 334-339. DOI: 10.1542/ peds.2010-1911.
[5]	周明月, 莫宝庆. 学龄前儿童屈光不正相关因素研究进展. 中国妇幼保健, 2019, 34(3): 719-722. DOI: 10.7620/zgfybj. j.issn.1001-4411.2019.03.76.
[6]	Ramamurthy D, Lin Chua SY, Saw SM. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom, 2015, 98(6): 497- 506. DOI: 10.1111/cxo.12346.
[7]	Adams RJ, Dalton SM, Murphy AM, et al. Testing young infants with the Welch Allyn suresight non-cycloplegic autorefractor. Ophthalmic Physiol Opt, 2002, 22(6): 546-551. DOI: 10.1046/ j.1475-1313.2002.00073.x.
[8]	宋生芳, 项道满, 胡兰香, 等. Welch Allyn Suresight 1和2视力筛查仪与Topcon电脑验光仪及视网膜检影屈光检查结果对照研究. 中国实用眼科杂志, 2016, 34(3): 210-215. DOI: 10.3760/cma.j.issn.1006-4443.2016.03.003.
[9]	伏幼娟, 杨静, 蒋炜. Suresight筛查仪在儿童视力筛查中应用的系统评价. 中国妇幼保健, 2019, 34(8): 1787-1790. DOI: 10.7620/zgfybj.j.issn.1001-4411.2019.08.32.
[10]	陈良姝. 3352 例6 个月~3 岁婴幼儿视力筛查结果分析. 中国卫生产业, 2019, 16(26): 188-189. DOI: 10.16659/ j.cnki.1672-5654.2019.26.188.
[11]	国家卫生健康委. 关于印发近视防治指南、斜视诊治指南和弱视诊治指南的通知(国卫办医函[2018]393 号). [2018- 06-01][2021-12-22]http://www.nhc.gov.cn/cms-search/xxgk/ getManuscriptXxgk.htm?id=369a1d5d8f124bd6a792f48cf3454 b2e.
[12]	首都儿科研究所, 九市儿童体格发育调查协作组. 2015年中国九市七岁以下儿童体格发育调查. 中华儿科杂志, 2018, 56(3): 192-199. DOI: 10.3760/cma.j.issn.0578-1310.2018.03.008.
[13]	WHO. Guidelines on physical activity, sedentary behavior and sleep for children under 5 years of age. Geneva: WHO, 2019.
[14]	Mutti DO, Sinnott LT, Lynn Mitchell G, et al. Ocular component development during infancy and early childhood. Optom Vis Sci, 2018, 95(11): 976-985. DOI: 10.1097/OPX.0000000000001296.
[15]	吴广强, 魏宁, 吴兴香, 等. 6月龄～6岁儿童屈光筛查界值点的研究. 中国儿童保健杂志, 2019, 27(12): 1365-1367. DOI: 10.11852/zgetbjzz2019-0351.
[16]	American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel. Preferred practice pattern®: pediatric eye evaluations PPP-2017. [2017-11-01] [2021-03-27].
[17]	李琳. 开封市 1359 例婴幼儿屈光状态调查分析. 中国妇幼卫生杂志, 2019, 10(6): 55-58,62. DOI: 10.19757/j.cnki. issn1674-7763.2019.06.011.
[18]	崔金玉, 徐韬, 武一萍, 等. 北京市西城区婴幼儿条栅视力和屈光度发育水平纵向监测研究. 中国妇幼卫生杂志, 2019, 10(3): 36-39. DOI: 10.19757/j.cnki.issn1674-7763.2019.03.009.
[19]	麦伟虎, 郭梦颖, 林选球. 海口市学龄前儿童视力及屈光状况分析. 中国学校卫生, 2017, 38(9): 1382-1384. DOI: 10.16835/ j.cnki.1000-9817.2017.09.030.
[20]	Wen G, Tarczy-Hornoch K, McKean-Cowdin R, et al. Prevalence of myopia, hyperopia, and astigmatism in non- Hispanic white and Asian children: multi-ethnic pediatric eye disease study. Ophthalmology, 2013, 120(10): 2109-2116. DOI: 10.1016/j.ophtha.2013.06.039.
[21]	李谐, 邹海东, 何鲜桂, 等. SureSight手持验光仪在3~6 岁儿童屈光不正筛查中的应用. 中华眼视光学与视觉科学杂志, 2015, 17(2): 99-102. DOI: 10.3760/cma.j.issn.1674- 845X.2015.02.009.
[22]	Cook A, White S, Batterbury M, et al. Ocular growth and refractive error development in premature infants without retinopathy of prematurity. Invest Ophthalmol Vis Sci, 2003, 44(3): 953-960. DOI: 10.1167/iovs.02-0124.
[23]	Tideman J, Polling JR, Jaddoe V, et al. Growth in foetal life, infancy, and early childhood and the association with ocular biometry. Ophthalmic Physiol Opt, 2019, 39(4): 245-252. DOI: 10.1111/opo.12630.
[24]	劳吉梦, 毛剑波, 朱琳, 等. 早产儿出生后早期屈光系统发育及其影响因素. 中华眼视光学与视觉科学杂志, 2020, 22(8): 602-606. DOI: 10.3760/cma.j.cn115909-20190715-00196.
[25]	Hennein L, Koo E, Robbins J, et al. Amblyopia risk factors in premature children in the first 3 years of life. J Pediatr Ophthalmol Strabismus, 2019, 56(2): 88-94. DOI: 10.3928/01913913-20190122-02.
[26]	Kaya M, Berk A T, Yaman A. Long-term evaluation of refractive changes in eyes of preterm children: a 6-year follow-up study. Int Ophthalmol, 2018, 38(4): 1681-1688. DOI: 10.1007/s10792- 017-0642-z.
[27]	Ma Q, Xu W, Zhou X, et al. The relationship of season of birth with refractive error in very young children in eastern China. PLoS One, 2014, 9(6): e100472. DOI: 10.1371/journal. pone.0100472.
[28]	Chua SY, Ikram MK, Tan CS, et al. Relative contribution of risk factors for early-onset myopia in young Asian children. Invest Ophthalmol Vis Sci, 2015, 56(13): 8101-8107. DOI: 10.1167/ iovs.15-16577.
[29]	曹敏辉, 杨夏敏, 安琪, 等. 莫廷视力筛查仪对264例婴幼儿视力屈光参数纵向监测的结果分析. 中国儿童保健杂志, 2016, 24(10): 1073-1076. DOI: 10.11852/zgetbjzz2016-24-10-18.
[30]	Liu F, Yang X, Tang A, et al. Association between mode of delivery and astigmatism in preschool children. Acta Ophthalmol, 2018, 96(2): e218-e221. DOI: 10.1111/aos.13552.
[31]	Northstone K, Guggenheim JA, Howe LD, et al. Body stature growth trajectories during childhood and the development of myopia. Ophthalmology, 2013, 120(5): 1064-1073.e1. DOI: 10.1016/j.ophtha.2012.11.004.
[32]	程天宇, 何鲜桂, 汪玲. 青少年屈光发育与青春期生长发育的研究进展. 上海预防医学, 2019, 31(5): 338-343. DOI: 10.19428/j.cnki.sjpm.2019.19344.
[33]	王立华, 陈巍, 冯晶晶, 等. 北京市海淀区2~3 岁幼儿视力和屈光状态筛查结果分析. 中华眼视光学与视觉科学杂志, 2016, 18(8): 478-482,487. DOI: 10.3760/cma.j.issn.1674- 845X.2016.08.007.