title: The relationship of season of birth with refractive error in very young children in eastern China.
abstract: OBJECTIVE
  To determine the association of season of birth and refractive error in very young Chinese children in China.
  
  
  METHODS
  We conducted a population-based study of Chinese children aged 0 to 3 years residing in eastern China. Refraction was determined by non-cyclopegic autorefraction using a hand-held autorefractor. Date of birth was retrieved from birth certificate of the individual subjects. A generalized linear regression model was fitted to estimate the regression coefficient and 95% confidence interval (CI) of refractive error for season of birth, adjusting for confounders.
  
  
  RESULTS
  Of the 1385 children eligible to participate, 1222 (88.2%) were examined. Refractive error data were available for 1219 children. The mean spherical equivalent were 1.21 diopters (D) in children born Spring, 1.24 D in those born in Summer, 1.23 D in those born in Autumn, 1.15 D in Winter. After adjusting for age, sex, father's educational level, birth weight and the number of summers between birth and examination date the children have been exposed to, children born in winter had a 0.12 D more myopic refraction compared with those born in summer (regression coefficient: -0.12; 95% CI, -0.27,-0.06; P = 0.006). The association between season of birth and cylinder power was not statistically significant.
  
  
  CONCLUSIONS
  In China, children born in winter had a more myopic refraction compared with those born in other seasons. The observed association between season of birth and refractive error was independent of parental educational level and birth weight, suggesting that light level may have a small impact on refractive development in early life.
authors.affiliation: School of Public Health, Medical College of Soochow University, Suzhou, China; The 3rd People's Hospital of Xiangcheng District, Suzhou, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Ma
authors.affiliation: The 3rd People's Hospital of Xiangcheng District, Suzhou, China.
authors.forename: Wenxin
authors.initials: W
authors.lastname: Xu
authors.affiliation: The 3rd People's Hospital of Xiangcheng District, Suzhou, China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Zhou
authors.affiliation: School of Public Health, Medical College of Soochow University, Suzhou, China.
authors.forename: Chunxue
authors.initials: C
authors.lastname: Cui
authors.affiliation: School of Public Health, Medical College of Soochow University, Suzhou, China.
authors.forename: Chen-Wei
authors.initials: CW
authors.lastname: Pan
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D036801:Parturition; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology*; D012621:Seasons