[Preliminary observations on the influence of maternal pregnancy factors and birth factors on pediatric astigmatism].

Objective: To investigate the impact of maternal factors during pregnancy and birth factors on astigmatism in children. Methods: It was a case-control study. Patients aged 3 to 12 years old were continuously selected from October 2023 to January 2024 in the Pediatric Eye Care Department of Qinhuangdao Maternal and Child Health Care Hospital. Children with astigmatism were included as the case group, and children without astigmatism were included as the control group. All children underwent cycloplegic autorefraction. Astigmatism was defined as a cylinder refractive error with an absolute value of≥1.00 diopter. Only the right eye were included in the analysis. The maternal factors during pregnancy [maternal age at delivery, delivery mode, paternal age, progesterone during pregnancy, pre-pregnancy body mass index (BMI), gestational weight gain, smoking during pregnancy, hypertensive disorders of pregnancy, gestational diabetes mellitus] and children's birth history [birth weight, birth order, BMI, preterm birth, nuchal cord] were recorded. The independent t-test, non-parametric test, and Chi-square test were used for comparison between groups. Multiple logistic regression analysis was performed and risk factors during pregnancy for astigmatism in children were identified by calculating the odds ratio (OR) and its 95% confidence interval (95%CI). Results: A total of 146 children (146 eyes) were included in the case group, consisting of 73 males and 73 females with a median age of 6 (5, 9) years, and 161 children (161 eyes) were included in the control group, consisting of 73 males and 88 females with a median age of 7 (5, 9) years. No statistically significant differences in age and gender were found between the two groups (all P>0.05). Multiple logistic regression analysis, with adjustment for confounding factors, showed that the maternal pre-pregnancy BMI 24.0 to <28.0 kg/m2 (OR=2.79, 95% CI: 1.46 to 5.35, P=0.002) or ≥28.0 kg/m2 (OR=3.97, 95% CI: 1.19 to 13.21, P=0.024), birth weight <2.5 kg (OR=5.44, 95% CI: 1.10 to 26.88, P=0.038), and birth order ≥ 2 (OR=2.06, 95% CI: 1.16 to 3.66, P=0.013) were risk factors of astigmatism in children. Conclusions: Higher maternal pre-pregnancy weight, lower birth weight, and non-firstborn status were associated with pediatric astigmatism.