足月新生儿屈光状态及其影响因素

Distribution and Influencing Factors of Refractive Status in Term Neonates

目的:获得足月新生儿基线屈光状态的数据并分析其影响因素。方法:横断面研究。采用简单随机抽样的方法纳入2022年1—10月于北京市海淀区妇幼保健院出生的足月新生儿379例(758眼)。通过检影验光获得睫状肌麻痹后的屈光度并计算等效球镜度(SE)。比较不同性别、眼别、日龄、孕周、出生身长、出生体质量、生产方式、父母双方近视度数之间屈光度的差异,分析SE与各参数之间的相关性并筛选SE的影响因素。采用秩和检验进行差异性检验,采用Spearman分析进行相关性分析,采用多元线性回归筛选SE的影响因素。结果:新生儿SE为+3.00(+1.75,+4.00)D,左眼高于右眼,差异有统计学意义(Z=-2.70,P=0.007);出生后1个月内,日龄越大,SE越低,差异有统计学意义(χ^(2)=21.89,P<0.001);巨大儿SE高于体质量正常新生儿,差异有统计学意义(χ^(2)=13.36,P=0.001);父亲或母亲为高度近视的新生儿SE低于父母为中低度近视或无近视者,差异有统计学意义(χ^(2)=11.60,P=0.003;χ^(2)=13.50,P=0.001)。SE与日龄(r=-0.12,P=0.001)、父亲近视度数(r=-0.11,P=0.003)和母亲近视度数(r=-0.11,P=0.002)呈负相关,与出生体质量(r=0.11,P=0.002)呈正相关。多元线性回归筛选出眼别、日龄、出生体质量、父亲近视度数和母亲近视度数是新生儿SE的显著相关要素(均P<0.05)。结论:足月新生儿屈光状态为轻中度远视,左眼远视度高于右眼,出生后1个月内日龄越大SE越低,SE与出生体质量呈正相关,与父母近视程度呈负相关。

Objective:To investigate the refractive status and its influencing factors in term neonates.Methods:In this cross-sectional study,a total of 379 full-term neonates(758 eyes)born in Haidian Maternal and Child Health Hospital were included using a simple random sampling method.Diopter was obtained by retinoscopy after cycloplegia,and the spherical equivalent(SE)was calculated.The SE of different genders,eyes type,age,gestational age,birth length,birth weight,ways of delivery,father's myopia,and mother's myopia were compared by Rank sum test,and correlations were analyzed by Spearman correlation analysis.The influencing factors of SE were analyzed using multiple linear regression.Results:The median SE of these infants was+3.00(+1.75,+4.00)D.The SE of left eye was higher than the SE of right eye,showing statistically significant(Z=-2.70,P=0.007).In the first month of birth,the age(days)was associated with SE(χ^(2)=21.89,P<0.001).The SE in the macrosomia was higher than that in normal weight neonates(χ^(2)=13.36,P=0.001).The SE in newborns whose parents were high myopia was significantly lower than those whose parents were low myopia or no myopia(χ^(2)=11.60,P=0.003;χ^(2)=13.50,P=0.001).SE showed negative correlations with age(r=-0.12,P=0.001),father's myopia(r=-0.11,P=0.003),and mother's myopia(r=-0.11,P=0.002).SE showed positive correlations with birth weight(r=0.11,P=0.002).Regression analysis showed that the eye type,age,birth weight,father's myopia and mother's myopia were all associated with neonatal SE significantly(all P<0.05).Conclusions:The refractive status of term neonates was moderate to high hyperopia,and decreased within the first month of birth.The SE of left eye was higher than that in right eye.Birth weight was positively correlated with SE,while parental myopia was negatively correlated with SE.