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目的:探讨孕期营养与双生子散光眼形成的关系。方法:对28对双生子于生后3个月、6个月至少进行1次屈光检查,将双生子的眼散光状况与孕母孕期及双生子出生前、后的相关因素进行分析。同期随机抽取56例单胎儿作为对照。结果:双生子柱镜≥2D散光眼的检出率为53.57%,显著高于单胎婴儿(χ2=21.35,P<0.05)。双生子中有和无散光家族史的两组间,散光值比较差异有统计学意义(F=6.33,P=0.01)。母亲有早孕反应(OR=1.40,95%CI:1.10～5.13)、母亲孕中期骨密度(OR=1.44,95%CI:1.30～6.19)、血色素(OR=1.69,95%CI:1.03～2.78)、分娩时血清镁(OR=1.39,95%CI:1.03～1.89)、维生素A(OR=1.03,95%CI:1.01～1.06)、双生子脐血维生素D(OR=1.02,95%CI:1.00～1.04)和出生体重(OR=1.02,95%CI:1.00～1.03)与双生子散光眼的关联有统计学意义(P<0.05)。结论:母孕期营养状况影响双生子散光眼的形成,应在整个孕期针对性地对孕母进行营养指导,以降低婴儿散光眼的发生率。
Objective: To investigate the relationship between prenatal nutrition and the formation of twins astigmatism. Methods: 28 pairs of twins at 3 months after birth, 6 months at least 1 times the refractive examination, twin astigmatism and pregnant women during pregnancy and twins before and after birth were analyzed. In the same period, 56 single fetuses were randomly selected as control. Results: The detection rate of asplenospheric ≥2D astigmatism was 53.57%, significantly higher than that of single fetus (χ2 = 21.35, P <0.05). There was significant difference in astigmatism between two groups with and without family history of astigmatism (F = 6.33, P = 0.01). The mothers had an early pregnancy response (OR = 1.40, 95% CI: 1.10-5.13), and the second trimester BMD (OR = 1.44, 95% CI: 1.30-6.19), hemoglobin ), Serum magnesium (OR = 1.39, 95% CI: 1.03-1.89), vitamin A (OR = 1.03, 95% CI: 1.01-1.06), twin umbilical blood vitamin D (OR = 1.02, 95% CI : 1.00 ~ 1.04) and birth weight (OR = 1.02, 95% CI: 1.00 ~ 1.03) and twins astigmatism were statistically significant (P <0.05). Conclusion: The nutritional status of the first trimester affects the formation of twin astigmatism. Nutritional guidance should be given to pregnant women in the whole pregnancy so as to reduce the incidence of astigmatism in infants.