Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring
Authors: Hui Zhu, Xue You, Yu Jing, Yiyuan Chen, Yangqian Jiang, Yuan Lin, Tao Jiang, Rui Qin, Hong Lv, Qun Lu, Cong Liu, Xin Xu, Yuxin Liu, Tianyu Sun, Mengting Jiang, Bo Xu, Xiumei Han, Jiaping Chen, Yue Jiang, Xiaoyu Liu, Kun Zhou, Guangfu Jin, Hongxia Ma, Zhibin Hu, Hu Liu, Jiangbo Du, Hongbing Shen, Yankai Xia, Jiong Li, Chuncheng Lu, Yang Zhao, Wei Wu, Minjian Chen, Shanshan Geng, Ye Ding, Lei Huang, Shiyao Tao, Yuanyan Dou, Shuifang Lei, Kang Ke, Yanjie Zhang, Yiqun Xu, Jinghan Wang, Xianxian Zhu, Huixin Xue, Ming Gan, Shuxin Xiao, Weiting Wang, Di Pi, Chang Wang, Haowen Zhang, Bo Yang, Yufan Jin, Xiao Zhang, Yongbin Xiong, Xin Zou, Zheng Yong, Shuting Wu, Yue Qu, Qin Wang, Jie Chen, Ganchong Liao, Liya Pang, Dan Huang, Zhujun Fu, Zijin Wang, Yue Wang, Rui Li, Haohai Tong, Shu Han, Xiaoyan Zhao, Shiya Shen, Yun Wang, Wen Yan, Xiaoxiao Li, Andi Zhao, Danni Chen, Lei Liu, Wei Guo, Yingxiao Qian, Lei Hua, Qi Yan, Xiaoxia Zuo, Tong Zhang, Ziyi Ni, Yu Jing, Tiantian Zhou, Xiaoqi Zhu, Chenyu Zhou, Yuting Zhang, Yunfan Shi, Yuhong Feng, Chuxuan Zhang, Haodong Chi, Fanbo Sun, Jian Cui, Yan Gao, Xinyuan Yao, Meng Li, Jiahao Si, Shasha Xu, Xi Chen, Jiyu Zhang, Xinyu Zheng, Yelongzi Cao, Xiaodong Shao, Shuning Liu, Yuxi Chen, Qin Shu, Shiding Li, Jingsong Dang, Tao Zhang, Ranran Ding, Yuemin Wu, Liyuan Wang, Ningjing Zhao, Jiajia Yang, Shuoyang Zhao, Yichao Qian, Yao Lu, Yue Zhu, Fanfei Ma, Changqin Zhang, Yuxiao Xu, Yan Zhu, Weiyi Dong, Mengqi Dong, Zhitong Li, Jing Sun, Yuxiang Yi, Hongxue Fu, Jie Dou, Wanting Gao, Zhuorong Li, Leyan Sun, Lan Tang, Xinyan Xu, Jingwen Yang, Ping Xue, Shengxiang Huang, Yidan Xia, Sirui Gu, Yaxin Chen, Yizheng Zhang, Qi Chen, Ruize Wu, Anqi Shi, Yujie Jiang, Rui Xu, Linting Mei, Xuexian Zhu, Yiting Wang, Xianyue Liang, Jing Xu, Zheng Zhang, Chengfei Xu, Jin Liu, Yucao Wang, Jinghan Liang, Jiaxu Li, Junyi You, Zhiying Lin, Wenjie Zhou, Zihan Yin, Cheng Sun, Difei Zuo, Ruini Zhu, Qikun Deng, Yujiao Shi, Yujie Wang, Zhen Wang, Xiaoyu Fan, Xinying Li
Journal: JAMA Network Open (2024)

Importance Maternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear. Objective To examine the association of maternal HDP with overall and type-specific strabismus in offspring. Design, Setting, and Participants In the Jiangsu Birth Cohort study, a population-based study in China, pregnant women were recruited from April 24, 2014, to November 30, 2018. A total of 6195 offspring had maternal HDP diagnosis information, of whom 3078 were excluded due to having no information on ocular alignment or due to having ocular diseases other than strabismus or refractive error. Offspring underwent ocular examinations at 3 years of age, completed May 21, 2022. Data were analyzed from May 28, 2022, through December 15, 2023. Exposure Maternal HDP, categorized into hypertension and preeclampsia or with blood pressure (BP) well controlled (systolic BP, &amp;amp;lt;130; diastolic BP, &amp;amp;lt;80 mm Hg) and poorly controlled (systolic BP, ≥130; diastolic BP, ≥80 mm Hg). Main Outcomes and Measures The primary outcome was the incidence of strabismus in offspring. Poisson generalized linear mixed models were used to estimate the association between maternal HDP and strabismus. Results Among the included 3117 children (mean [SD] age, 36.30 [0.74] months; 1629 boys [52.3%]), 143 (4.6%) were exposed to maternal HDP and 368 (11.8%) had strabismus. Offspring exposed to maternal HDP had an 82% increased risk of overall strabismus (relative risk [RR], 1.82 [95% CI, 1.21-2.74]), an 82% increased risk of exophoria (RR, 1.82 [95% CI, 1.11-3.00]), and a 136% increased risk of intermittent exotropia (RR, 2.36 [95% CI, 1.13-4.93]) compared with unexposed offspring. When considering the type of maternal HDP, the risk for all strabismus was high for offspring exposed to preeclampsia (RR, 2.38 [95% CI, 1.39-4.09]) compared with unexposed offspring. When considering the BP control level of maternal HDP, the risk for all strabismus was high for offspring born to mothers with HDP and poorly controlled BP (RR, 2.07 [95% CI, 1.32-3.24]) compared with unexposed offspring. Conclusions and Relevance These findings suggest that maternal HDP is associated with an increased risk of offspring strabismus. Early screening of strabismus might be recommended for offspring with maternal HDP. Further exploration of the underlying mechanism of the association between HDP and strabismus is warranted.