{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:06Z","timestamp":1787016966281,"version":"build-2736575974"},"reference-count":35,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2023M730626"],"award-info":[{"award-number":["2023M730626"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Healthy Young Talents Project of Shanghai Municipal Health Commission","award":["2022YQ015"],"award-info":[{"award-number":["2022YQ015"]}]},{"DOI":"10.13039\/501100013105","name":"Shanghai Rising-Star Program","doi-asserted-by":"publisher","award":["23QA1401000"],"award-info":[{"award-number":["23QA1401000"]}],"id":[{"id":"10.13039\/501100013105","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271119; 82304260"],"award-info":[{"award-number":["82271119; 82304260"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Project of Shanghai Science and Technology","award":["20410710100"],"award-info":[{"award-number":["20410710100"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,1,17]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To identify factors contributing to rapid axial length (AL) growth in children aged 3\u20139 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four thousand four hundred thirty-five children were followed from 2019 to 2022. AL and corneal curvature were measured using an IOLMaster 500, while refractometry and visual acuity were also assessed. Baseline data included demographics and parental myopia status, with annual updates on height, weight and behavioural factors. Latent class growth model was used to discover AL trajectories, whereas multiple logistic regression was used to identify determinants of rapid AL elongation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all participants, baseline age and parental myopia influenced AL growth. Specifically, children aged 3\u20136 years exhibited faster AL elongation when engaging in persistent excessive homework time (OR, 2.86, 95% CI 1.31 to 6.95) and near-work activities (OR, 2.13, 95%\u2009CI 1.12 to 4.10). For the 7\u20139-year group, the risk factors of rapid AL growth included being female (OR, 2.05, 95% CI 1.45 to 2.90) and need myopia correction at baseline (OR, 3.19, 95%\u2009CI 2.02 to 5.02). Notably, actively engaging in outdoor activities had a protective effect in the 7\u20139-year group (OR, 0.65, 95%\u2009CI 0.43 to 0.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study delineates AL growth trajectories in children aged 3\u20139 years and highlights distinct risk factors for rapid AL growth. These findings underscore the necessity of implementing age-specific strategies for myopia prevention and control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2024-326261","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T13:20:19Z","timestamp":1738329619000},"page":"1064-1073","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors for rapid axial length growth in a prospective cohort study of 3-year to 9-year-old Chinese children"],"prefix":"10.1136","volume":"109","author":[{"given":"Yanze","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhao","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingnan","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3465-1579","authenticated-orcid":false,"given":"Xingtao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China"},{"name":"Key laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2450-4137","authenticated-orcid":false,"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, 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The ministry of education and other three departments deploy prevention and control work for myopia at key stages in kindergartens and primary schools. 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