title: The Association between Maternal Reproductive Age and Progression of Refractive Error in Urban Students in Beijing.
abstract: OBJECTIVE
  To investigate the association between maternal reproductive age and their children' refractive error progression in Chinese urban students.
  
  
  METHODS
  The Beijing Myopia Progression Study was a three-year cohort investigation. Cycloplegic refraction of these students at both baseline and follow-up vision examinations, as well as non-cycloplegic refraction of their parents at baseline, were performed. Student's refractive change was defined as the cycloplegic spherical equivalent (SE) of the right eye at the final follow-up minus the cycloplegic SE of the right eye at baseline.
  
  
  RESULTS
  At the final follow-up, 241 students (62.4%) were reexamined. 226 students (58.5%) with completed refractive data, as well as completed parental reproductive age data, were enrolled. The average paternal and maternal age increased from 29.4 years and 27.5 years in 1993-1994 to 32.6 years and 29.2 years in 2003-2004, respectively. In the multivariate analysis, students who were younger (β = 0.08 diopter/year/year, P<0.001), with more myopic refraction at baseline (β = 0.02 diopter/year/diopter, P = 0.01), and with older maternal reproductive age (β = -0.18 diopter/year/decade, P = 0.01), had more myopic refractive change. After stratifying the parental reproductive age into quartile groups, children with older maternal reproductive age (trend test: P = 0.04) had more myopic refractive change, after adjusting for the children's age, baseline refraction, maternal refraction, and near work time. However, no significant association between myopic refractive change and paternal reproductive age was found.
  
  
  CONCLUSIONS
  In this cohort, children with older maternal reproductive age had more myopic refractive change. This new risk factor for myopia progression may partially explain the faster myopic progression found in the Chinese population in recent decades.
authors.affiliation: The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Lin
authors.affiliation: The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; School of Environmental Science & Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Guang Yun
authors.initials: GY
authors.lastname: Mao
authors.affiliation: College of Optometry, Mid Western University, Glendale, AZ, United States of America.
authors.forename: Balamurali
authors.initials: B
authors.lastname: Vasudevan
authors.affiliation: The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Zi Bing
authors.initials: ZB
authors.lastname: Jin
authors.affiliation: Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, United States of America.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ciuffreda
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
authors.affiliation: The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Hong Jia
authors.initials: HJ
authors.lastname: Zhou
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China.
authors.forename: Ning Li
authors.initials: NL
authors.lastname: Wang
authors.affiliation: The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Yuan Bo
authors.initials: YB
authors.lastname: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D000068476:Beijing / Q000453:epidemiology; D002648:Child; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D012030:Refractive Errors / Q000453:epidemiology* / Q000473:pathology; D013334:Students