New research provides insights into the ocular health of children who were exposed to preeclampsia, poorly controlled blood pressure, and other maternal hypertensive disorders in utero.
“Previous studies imply that aberrant fetal growth and suboptimal intrauterine environments may contribute to the onset of strabismus,” the researchers explained in their report, published in JAMA Network Open.
The study utilized data from the Jiangsu Birth Cohort, a subset of the China National Birth Cohort study. From April 2014 to November 2018, pregnant women were recruited, and their children were followed up for ocular examinations at 3 years of age. The final analysis included 3,117 children, 143 of whom were exposed to maternal HDP. The study categorized maternal hypertensive disorders in pregnancy (HDP) as hypertension and preeclampsia, further classified by blood pressure control levels during labor. They also analyzed risk “when HDP was complicated with diabetes in pregnancy (DIP).”
The investigators found that “offspring born to mothers with HDP had an 82% higher overall risk of strabismus,” which was further broken down into type-specific strabismus: there was an 82% increased risk for exophoria and a 136% increased risk for intermittent exotropia. They also found that “the risk for all strabismus was high for offspring exposed to preeclampsia compared with unexposed offspring. This trend was apparent in exophoria, but not in intermittent exotropia. The highest risk was observed in offspring exposed to preeclampsia and poorly controlled blood pressure.”
No association between maternal DIP and strabismus was found.
Further research is needed to understand mechanisms during pregnancy, as well as other confounding factors such as family history, that cause abnormalities in binocular vision. For now, though, the researchers suggested considering early screening for strabismus, particularly in pediatric patients whose mothers had been diagnosed with preeclampsia or poorly controlled blood pressure.
A full list of author disclosures can be found in the published research.