Owen, CG;
Oken, E;
Rudnicka, AR;
Patel, R;
Thompson, J;
Rifas-Shiman, SL;
Vilchuck, K;
Bogdanovich, N;
Hameza, M;
Kramer, MS;
et al.
Owen, CG; Oken, E; Rudnicka, AR; Patel, R; Thompson, J; Rifas-Shiman, SL; Vilchuck, K; Bogdanovich, N; Hameza, M; Kramer, MS; Martin, RM
(2018)
The Effect of Longer-Term and Exclusive Breastfeeding Promotion on Visual Outcome in Adolescence.
Invest Ophthalmol Vis Sci, 59 (7).
pp. 2670-2678.
ISSN 1552-5783
https://doi.org/10.1167/iovs.17-23211
SGUL Authors: Owen, Christopher Grant Rudnicka, Alicja Regina
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Abstract
Purpose: Breastfeeding may influence early visual development. We examined whether an intervention to promote increased duration and exclusivity of breastfeeding improves visual outcomes at 16 years of age. Methods: Follow-up of a cluster-randomized trial in 31 Belarusian maternity hospitals/polyclinics randomized to receive a breastfeeding promotion intervention, or usual care, where 46% vs. 3% were exclusively breastfed at 3 months respectively. Low vision in either eye was defined as unaided logMAR vision of ≥0.3 or worse (equivalent to Snellen 20/40) and was used as the primary outcome. Open-field autorefraction in a subset (n = 963) suggested that 84% of those with low vision were myopic. Primary analysis was based on modified intention-to-treat, accounting for clustering within hospitals/clinics. Observational analyses also examined the effect of breastfeeding duration and exclusivity, as well as other sociodemographic and environmental determinants of low vision. Results: A total of 13,392 of 17,046 (79%) participants were followed up at 16 years. Low vision prevalence was 19.6% (95% confidence interval [CI]: 17.5, 22.0%) in the experimental group versus 21.6% (19.5, 23.8%) in the control group. Cluster-adjusted odds ratio (OR) of low vision associated with the intervention was 0.92 (95% CI: 0.73, 1.16); 0.88 (95% CI: 0.74, 1.05) after adjustment for parental and early life factors. In observational analyses, breastfeeding duration and exclusivity had no significant effect on low vision. However, maternal age at birth (OR: 1.13, 95% CI: 1.07, 1.14/5-year increase) and urban versus rural residence were associated with increased risk of low vision. Lower parental education, number of older siblings was associated with a lower risk of low vision; boys had lower risk compared with girls (0.64, 95% CI: 0.59,0.70). Conclusions: Exclusive breastfeeding promotion had no significant effect on visual outcomes in this study, but other environmental factors showed strong associations. (ClinicalTrials.gov number, NCT01561612.)
Item Type: | Article | |||||||||||||||
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Additional Information: | Copyright 2018 The Authors This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0). | |||||||||||||||
Keywords: | Ophthalmology & Optometry, 11 Medical And Health Sciences, 06 Biological Sciences | |||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Population Health Research Institute (INPH) | |||||||||||||||
Journal or Publication Title: | Invest Ophthalmol Vis Sci | |||||||||||||||
ISSN: | 1552-5783 | |||||||||||||||
Language: | eng | |||||||||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | |||||||||||||||
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PubMed ID: | 29860453 | |||||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/109822 | |||||||||||||||
Publisher's version: | https://doi.org/10.1167/iovs.17-23211 |
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