Impact of Prenatal Exposure to Opioids, Cocaine, and Cannabis on Eye Disorders in Children
Impact of Prenatal Exposure to Opioids, Cocaine, and Cannabis on Eye Disorders in Children
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DOI：
10.1097/adm.0000000000000621
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发表时间：
2020-12-01
影响因子：
5.5
通讯作者：
Thuy Mai Luu
中科院分区：
文献类型：
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作者：
Auger, Nathalie;Rheaume, Marc-Andre;Thuy Mai Luu
目的：产前物质暴露与后代视觉诱发电位异常有关，但婴儿后是否存在眼部异常尚不清楚。我们确定了产前物质暴露与儿童眼病住院之间的关系。方法：我们对2006年至2016年在加拿大魁北克省所有医院中心出生的794,099名婴儿进行了纵向队列研究。我们确定了产前暴露于阿片类药物、可卡因、大麻和其他非法物质的婴儿，并对他们进行了一段时间的随访，以评估需要住院治疗的眼部疾病，包括视网膜脱离和断裂、斜视和其他眼部病变。我们计算了产前物质暴露与眼部疾病风险相关性的发生率和风险比（HR）， 95%可信区间（CI），并根据患者特征进行了调整。结果：与未暴露于物质的婴儿相比，产前暴露于物质的婴儿因眼部疾病住院的发生率更高（47.0 vs 32.0 / 10000人年）。产前物质暴露与儿童期任何眼部疾病住院风险的1.23倍相关（95% CI 1.04-1.45）。斜视（HR 1.55, 95% CI 1.16-2.07）和双眼运动障碍（HR 1.96, 95% CI 1.00-3.83）的风险最大。阿片类药物的使用与眼肌疾病的风险密切相关（HR 3.15, 95% CI 1.98-5.01）。结论：产前物质暴露与未来儿童眼病住院治疗显著相关。鉴于目前阿片类药物的流行，需要努力尽量减少育龄妇女的药物使用。
Objectives: Prenatal substance exposure is associated with abnormal visual evoked potentials in offspring, but whether ocular abnormalities are present past infancy is unclear. We determined the association between prenatal substance exposure and hospitalizations for eye disorders in childhood. Methods: We conducted a longitudinal cohort study of 794,099 infants born between 2006 and 2016 in all hospital centers in Quebec, Canada. We identified infants prenatally exposed to opioids, cocaine, cannabis, and other illicit substances and followed them over time to assess eye disorders that required in-hospital treatment, including retinal detachment and breaks, strabismus, and other ocular pathologies. We calculated incidence rates and hazard ratios (HR) with 95% confidence intervals (CI) for the association of prenatal substance exposure with risk of eye disorders, adjusted for patient characteristics. Results: Infants exposed to substances prenatally had a higher incidence of hospitalizations for eye disorders compared with unexposed infants (47.0 vs 32.0 per 10,000 person-years). Prenatal substance exposure was associated with 1.23 times the risk of hospital admission for any eye disorder during childhood compared with no exposure (95% CI 1.04-1.45). Risks were greatest for strabismus (HR 1.55, 95% CI 1.16-2.07) and binocular movement disorders (HR 1.96, 95% CI 1.00-3.83). Opioid use was strongly associated with the risk of ocular muscle disorders (HR 3.15, 95% CI 1.98-5.01). Conclusions: Prenatal substance exposure is significantly associated with future hospitalizations for eye disorders in childhood. Efforts to minimize substance use in women of reproductive age are needed in light of the current opioid epidemic.