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

Abstract

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.

Association of Birth Weight with Peripapillary Retinal Nerve Fiber Layer Thickness in Adulthood—Results from a Population-Based Study

“…5 Rothman and colleagues 6 observed a correlation between brain structure and peripapillary retinal nerve fiber layer (pRNFL) thinning in preterm infants (gestational age < 32 weeks). Scarce population-based data exist regarding the association of low birth weight and pRNFL in childhood, 7 whereas to our knowledge no population-based data exist for this relationship in adulthood.…”

“…10 In the population-based Copenhagen Child Cohort 2000 Eye Study, thinner pRNFL thickness was found in former low-birth-weight infants (<2500 g; 11 to 12 years of age at the time of the study) compared to former normal birth weight infants (≥2500 g). 7 Thinner pRNFL is associated with various optic neuropathies, particularly glaucoma, which is one of the main eye diseases causing visual impairment and blindness in Western countries. 14 Therefore, gaining knowledge about the factors affecting the pRNFL is of importance and may contribute to a better understanding of potential risk factors for glaucoma.…”

Efectos de la exposición prenatal a alcohol, tabaco y otras drogas de abuso sobre el desarrollo retiniano

“…Es mucha la literatura existente acerca de alteraciones a nivel funcional, aunque muy poca relativa a alteraciones orgánicas o morfométricas. En el estudio llevado a cabo por Pueyo et al 24 y posteriormente en el realizado por Ashina et al 25 se demostró que la exposición prenatal al tabaco produce una alteración del desarrollo del nervio óptico en humanos, encontrándose un adelgazamiento de CFNR, independiente del peso al nacer. Estos resultados son congruentes con los encontrados en nuestro estudio, donde las medidas retinianas tomadas en el grupo de los niños cuyas madres fueron fumadoras durante el embarazo fueron peores que las del grupo control, a pesar de no encontrar diferencia estadísticamente significativa, probablemente por contar con un menor número de muestra que en los citados trabajos.…”

Small Hard Macular Drusen and Associations in 11- to 12-Year-Old Children in the Copenhagen Child Cohort 2000 Eye Study

“…Previous reports on the CCC2000 eye study cohort cover choroidal and retinal nerve fiber layer thickness and optic disc drusen characteristics [15][16][17][18] and the details of the protocol. 15 In brief, all participants and their parents were asked about the participants' ophthalmic history, and anthropometric measures were obtained including weight and height.…”

“…14 The ethnicity of the children was indirectly assessed by the maternal citizenship code as registered in the Danish Civil Registration System as described in a previous report. 16 All subjects underwent a general ophthalmic examination including nonmydriatic fundus photography with fovea-and disc-centered 458 digital color fundus photography (Topcon Mark II TRC-NW7SF; Topcon Corp., Tokyo, Japan). Fundus characteristics were assessed by an ophthalmologist (ICM) who was masked to all parameters.…”