TY - JOUR

T1 - Association of Maternal Smoking During Pregnancy and Birth Weight With Retinal Nerve Fiber Layer Thickness in Children Aged 11 or 12 Years

T2 - The Copenhagen Child Cohort 2000 Eye Study

AU - Ashina, Håkan

AU - Li, Xiao Qiang

AU - Olsen, Else Marie

AU - Skovgaard, Anne Mette

AU - Larsen, Michael

AU - Munch, Inger Christine

PY - 2017

Y1 - 2017

N2 - Importance: Both maternal smoking during pregnancy and low birth weight have been implicated in impaired development of the retina.Objective: To investigate the associations of maternal smoking during pregnancy and low birth weight with retinal nerve fiber layer (RNFL) thickness in preadolescent children.Design, Setting, Participants: The Copenhagen Child Cohort 2000 Eye Study is a prospective, population-based, birth cohort study that included all children (n = 6090) born in 2000 in Copenhagen, Denmark. Maternal smoking data were collected through parental interviews. Birth weight, pregnancy, and medical history data were obtained from the Danish Medical Birth Registry. As a follow-up, the study performed eye examinations on 1406 of these children from May 1, 2011, to October 31, 2012, when the children were aged 11 or 12 years. The participants were predominantly (1296 [92.4%]) of European descent. Study data were analyzed from June 1, 2016, to October 1, 2016.Main Outcomes and Measures: Peripapillary RNFL thickness measured using optical coherence tomography at the 11- or 12-year examination.Results: Of the 1406 children in the study, 1323 were included in the analysis (mean [SD] age was 11.7 [0.4] years; 633 [47.8%] were boys and 690 [52.2%] were girls). The mean (SD) RNFL thickness was 104 (9.6) μm. In 227 children whose mothers had smoked during pregnancy, the peripapillary RNFL was 5.7 μm (95% CI, 4.3-7.1 μm; P < .001) thinner than in children whose mothers had not smoked after correction for age, sex, birth weight, height, body weight, Tanner stage of pubertal development, axial length, and spherical equivalent refractive error. In low-birth-weight children (<2500 g), the RNFL was 3.5 μm (95% CI, 0.6-6.3 μm; P = .02) thinner than in normal-birth-weight children after adjustment for all variables.Conclusions and Relevance: Exposure to maternal smoking during uterine life and low birth weight were independently associated with having a thinner RNFL at age 11 or 12 years. These observations support previous findings that intrauterine and perinatal factors can have long-lasting effects on the retina and the optic nerve. The results of this study add evidence to existing recommendations to avoid smoking during pregnancy and support measures that promote maternal and fetal health.

AB - Importance: Both maternal smoking during pregnancy and low birth weight have been implicated in impaired development of the retina.Objective: To investigate the associations of maternal smoking during pregnancy and low birth weight with retinal nerve fiber layer (RNFL) thickness in preadolescent children.Design, Setting, Participants: The Copenhagen Child Cohort 2000 Eye Study is a prospective, population-based, birth cohort study that included all children (n = 6090) born in 2000 in Copenhagen, Denmark. Maternal smoking data were collected through parental interviews. Birth weight, pregnancy, and medical history data were obtained from the Danish Medical Birth Registry. As a follow-up, the study performed eye examinations on 1406 of these children from May 1, 2011, to October 31, 2012, when the children were aged 11 or 12 years. The participants were predominantly (1296 [92.4%]) of European descent. Study data were analyzed from June 1, 2016, to October 1, 2016.Main Outcomes and Measures: Peripapillary RNFL thickness measured using optical coherence tomography at the 11- or 12-year examination.Results: Of the 1406 children in the study, 1323 were included in the analysis (mean [SD] age was 11.7 [0.4] years; 633 [47.8%] were boys and 690 [52.2%] were girls). The mean (SD) RNFL thickness was 104 (9.6) μm. In 227 children whose mothers had smoked during pregnancy, the peripapillary RNFL was 5.7 μm (95% CI, 4.3-7.1 μm; P < .001) thinner than in children whose mothers had not smoked after correction for age, sex, birth weight, height, body weight, Tanner stage of pubertal development, axial length, and spherical equivalent refractive error. In low-birth-weight children (<2500 g), the RNFL was 3.5 μm (95% CI, 0.6-6.3 μm; P = .02) thinner than in normal-birth-weight children after adjustment for all variables.Conclusions and Relevance: Exposure to maternal smoking during uterine life and low birth weight were independently associated with having a thinner RNFL at age 11 or 12 years. These observations support previous findings that intrauterine and perinatal factors can have long-lasting effects on the retina and the optic nerve. The results of this study add evidence to existing recommendations to avoid smoking during pregnancy and support measures that promote maternal and fetal health.

KW - Birth Weight

KW - Child

KW - Denmark

KW - Female

KW - Humans

KW - Infant, Low Birth Weight

KW - Male

KW - Maternal Behavior

KW - Nerve Fibers

KW - Optic Disk

KW - Pregnancy

KW - Prenatal Exposure Delayed Effects

KW - Prospective Studies

KW - Retinal Diseases

KW - Retinal Ganglion Cells

KW - Risk Factors

KW - Smoking

KW - Tomography, Optical Coherence

KW - Visual Acuity

KW - Journal Article

U2 - 10.1001/jamaophthalmol.2017.0043

DO - 10.1001/jamaophthalmol.2017.0043

M3 - Journal article

C2 - 28253396

VL - 135

SP - 331

EP - 337

JO - JAMA Ophthalmology

JF - JAMA Ophthalmology

SN - 2168-6165

IS - 4

ER -