Risk factors in term children for visual impairment without a known prenatal or postnatal cause.

Risk factors were studied for visual impairment in children without known pre- or postnatal cause, for a decrease of visual acuity. Children born at term 1979-98 and with a visual impairment were identified from the Swedish Register of Visually Impaired Children and data were linked with the Swedish Medical Birth Registry. Maternal characteristics such as maternal age, parity, maternal smoking habits in early pregnancy, maternal education, nationality, and subfertility were studied as well as maternal diagnoses such as pre-eclampsia, prolonged second stage of labour, abruptio placentae, and placenta praevia. Mode of delivery was analysed as well as birthweight, and birthweight in relation to gestational age. Abruptio placentae turned out to be the strongest risk factor (OR = 8.24 [95% CI 5.01, 13.51]). Smoking did not give a statistically significant increased risk. There is an increased risk with breech delivery (OR = 2.01 [95% CI 1.28, 3.17]). Pre-eclampsia was associated with an increased risk (OR = 2.22 [95% CI 1.46, 3.38]). There is also an increase in risk at low birthweight and small-for-gestational-age as well as birthweight > 4 kg and large-for-gestational-age. In this study we found that risk factors particularly worth noticing in term children with a presumed perinatal cause of visual impairment are abruptio placentae, pre-eclampsia, excessively low as well as excessively high birthweight, and breech delivery, a fact worth noticing in current discussion on risks, advantages or excessive exploitation of caesarean section.

[1]  K. Tornqvist,et al.  Visual impairment in Swedish children. III. Diagnoses. , 2009, Acta ophthalmologica Scandinavica.

[2]  K. Tornqvist,et al.  Visual impairment in Swedish children. II. Etiological factors. , 2009, Acta ophthalmologica Scandinavica.

[3]  Lois E. H. Smith,et al.  Low IGF-I suppresses VEGF-survival signaling in retinal endothelial cells: Direct correlation with clinical retinopathy of prematurity , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[4]  B Hagberg,et al.  Changing panorama of cerebral palsy in Sweden. VIII. Prevalence and origin in the birth year period 1991–94 , 2001, Acta paediatrica.

[5]  Andrew R Willan,et al.  Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial , 2000, The Lancet.

[6]  G N Dutton,et al.  Periventricular leukomalacia: an important cause of visual and ocular motility dysfunction in children. , 2000, Survey of ophthalmology.

[7]  G. Holmström,et al.  Ophthalmological follow up of preterm infants: a population based, prospective study of visual acuity and strabismus , 1999, The British journal of ophthalmology.

[8]  G. Holmström,et al.  Ophthalmological long term follow up of preterm infants: a population based, prospective study of the refraction and its development , 1998, The British journal of ophthalmology.

[9]  R. Weale,et al.  The Epidemiology of Eye Disease , 1998 .

[10]  B Hagberg,et al.  The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth‐year period 1995–1998 , 1996, Acta paediatrica.

[11]  L. Jacobson,et al.  VISUAL IMPAIRMENT IN PRETERM CHILDREN WITH PERIVENTRICULAR LEUKOMALACIA — VISUAL, COGNITIVE AND NEUROPAEDIATRIC CHARACTERISTICS RELATED TO CEREBRAL IMAGING , 1996, Developmental medicine and child neurology.

[12]  B. Källén.  A birth weight for gestational age standard based on data in the Swedish Medical Birth Registry, 1985–1989 , 1995, European Journal of Epidemiology.

[13]  A. Slater,et al.  Visual deficits in children born at less than 32 weeks' gestation with and without major ocular pathology and cerebral damage. , 1995, The British journal of ophthalmology.

[14]  E. Herrgård,et al.  Ocular findings in prematurely born children at 5 years of age , 1993, Graefe's Archive for Clinical and Experimental Ophthalmology.

[15]  T. Rosenberg,et al.  Visual impairment in Nordic children , 1992, Acta ophthalmologica.

[16]  M. Warburg,et al.  Visual impairment in Nordic children , 1992, Acta ophthalmologica.

[17]  T. Rosenberg,et al.  Visual impairment in Nordic children , 1992, Acta ophthalmologica.

[18]  B. Källén,et al.  A Quality Study of a Medical Birth Registry , 1990, Scandinavian journal of social medicine.

[19]  T. L. Terry.  Extreme Prematurity and Fibroblastic Overgrowth of Persistent Vascular Sheath Behind Each Crystalline Lens* : I. Preliminary Report , 1942 .

[20]  A. Foster,et al.  Prevalence, incidence and distribution of visual impairment , 2003 .

[21]  K. Tornqvist,et al.  Visual impairment in Swedish children. I. Register and prevalence data. , 1997, Acta ophthalmologica Scandinavica.

[22]  Bengt Kaill.  A birth weight for gestational age standard based on data in the Swedish Medical Birth Registry, 1985-1989 , 1995 .