Maternal smoking during pregnancy: a risk factor for early childhood ophthalmologic conditions

BACKGROUND/AIMS: To investigate the association between maternal smoking during pregnancy and early childhood ophthalmologic conditions. METHODS: This population-based retrospective cohort study analysed data from infants born between 2014 and 2020 within a single healthcare system in Israel. Maternal smoking status was categorised by trimester of exposure and infants were followed for 3 years. Diagnoses were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and grouped into five categories: strabismus, refractive errors, congenital anomalies, inflammatory and infectious diseases and ocular tumours. Multivariable logistic regression was adjusted for infant gender, ethnicity, socioeconomic status, birth weight, gestational age and maternal age. RESULTS: Among 50 778 infants, 2830 (5.6%) were exposed to maternal smoking during pregnancy. Exposure was associated with increased risk of any ophthalmic condition (adjusted OR 1.15, 95% CI 1.04 to 1.26, p=0.004), strabismus (adjusted OR 1.34, 95% CI 1.06 to 1.69, p=0.013) and inflammatory and infectious diseases (adjusted OR 1.13, 95% CI 1.03 to 1.24, p=0.012). First-trimester exposure showed stronger associations with any ophthalmic condition (adjusted OR 1.16, 95% CI 1.01 to 1.33, p=0.034) and strabismus (adjusted OR 1.52, 95% CI 1.12 to 2.07, p=0.008). Exposure throughout pregnancy showed the strongest associations with any ophthalmic condition (adjusted OR 1.75, 95% CI 1.19 to 2.57, p=0.005), congenital anomalies (adjusted OR 1.85, 95% CI 1.01 to 3.37, p=0.045) and inflammatory/infectious diseases (adjusted OR 1.81, 95% CI 1.24 to 2.63, p=0.002). Refractive errors showed no significant difference. CONCLUSIONS: Maternal smoking during pregnancy, particularly in the first trimester, was associated with increased risk of multiple early childhood ophthalmologic conditions, highlighting the importance of smoking cessation during pregnancy to reduce potential risks to children's visual health.