{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T22:12:18Z","timestamp":1781043138553,"version":"3.54.1"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Growing evidence indicates that adverse prenatal or intrauterine environments might contribute to the development of high refractive error (RE) later in life. However, the association of maternal hypertensive disorder of pregnancy (HDP) with high RE in offspring during childhood and adolescence remains unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the association between maternal HDP and overall and type-specific high REs in offspring in childhood and adolescence.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This nationwide population-based cohort study included live-born individuals born in Denmark from 1978 to 2018 in the Danish national health registers. Follow-up started at the date of birth and ended at the date of RE diagnosis, 18th birthday, death, emigration, or December 31, 2018, whichever came first. Data analyses were conducted from November 12, 2021, through June 30, 2022.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Maternal HDP (n\u2009=\u2009104\u202f952), including preeclampsia or eclampsia (n\u2009=\u200970\u202f465) and hypertension (n\u2009=\u200934\u202f487).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcomes were the first occurrence of high RE (hyperopia, myopia, and astigmatism) in offspring. A Cox proportional hazards regression model was used to examine the association between maternal HDP and risk of high RE in offspring from birth until age 18 years, adjusting for multiple potential confounders.<\/jats:p><\/jats:sec>Results<\/jats:title>This study included 2\u202f537\u202f421 live-born individuals, 51.30% of whom were male. During the follow-up of up to 18 years, 946 offspring of 104\u202f952 mothers with HDP (0.90%) and 15\u202f559 offspring of 2\u202f432\u202f469 mothers without HDP (0.64%) were diagnosed with high RE. The cumulative incidence of high RE was higher in the exposed cohort (1.12%; 95% CI, 1.05%-1.19%) than in the unexposed cohort (0.80%; 95% CI, 0.78%-0.81%) at 18 years of age (difference: 0.32%; 95% CI, 0.25%-0.40%). Offspring born to mothers with HDP had a 39% increased risk of overall high RE (hazard ratio [HR], 1.39; 95% CI, 1.31-1.49). Sibling-matched analysis revealed an increased risk of overall high RE in half siblings (HR, 1.21; 95% CI, 1.05-1.39) and full siblings (HR, 1.15; 95% CI, 0.99-1.34), but the difference was not significant for the latter. The elevated risks were observed for hypermetropia (HR, 1.41; 95% CI, 1.30-1.52), myopia (HR, 1.30; 95% CI, 1.10-1.53), and astigmatism (HR, 1.45; 95% CI, 1.22-1.71). The increased risk of high RE persisted among offspring aged 0 to 6 years (HR, 1.51, 95% CI, 1.38-1.65), 7 to 12 years (HR, 1.28; 95% CI, 1.11-1.47), and 13 to 18 years (HR, 1.16; 95% CI, 0.95-1.41), but the difference was not significant for the oldest group. When considering both timing of diagnosis and severity of maternal preeclampsia, the highest risk was observed in offspring prenatally exposed to early-onset and severe preeclampsia (HR, 2.59; 95% CI, 2.17-3.08).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of the Danish population, maternal HDP, especially early-onset and severe preeclampsia, was associated with an increased risk of high RE in offspring during childhood and adolescence. These findings suggest that early and regular RE screening should be recommended for children of mothers with HDP.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.8694","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T15:48:41Z","timestamp":1681832921000},"page":"e238694","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence"],"prefix":"10.1001","volume":"6","author":[{"given":"Meiyan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Key Lab of Myopia, Ministry of Health, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of 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