Combination Effect of Outdoor Activity and Screen Exposure on Risk of Preschool Myopia: Findings From Longhua Child Cohort Study

Abstract

Evidence regarding screen use and outdoor activity during very early childhood (i. e., from aged 1 to 3 years) and their potential combined links to the later preschool myopia is limited. This information is needed to release effective public health messages and propose intervention strategies against preschool myopia. We collected information regarding very early childhood screen use, outdoor activity and the kindergartens vision screenings of 26,611 preschoolers from Longhua Child Cohort Study by questionnaires. Logistic regression models were used to examine the associations between reported outdoor activity, screen use from 1 to 3 years of age, and preschool myopia. Throughout very early childhood, from 1 to 3 years, the proportion of children exposed to screens increased (from 35.8 to 68.4%, p < 0.001), whereas the proportion of children who went outdoors ≥7 times/week (67.4–62.1%, p < 0.001) and who went outdoors for ≥60 min/time (53.3–38.0%, p < 0.001) declined. Exposure to fixed screen devices [adjusted odds ratio (AOR) = 2.66, 95% confidence interval (CI) = 2.09–3.44], mobile screen devices (AOR = 2.76, 95% CI = 2.15–3.58), and limited outdoor activity (AOR = 1.87, 95% CI = 1.42–2.51) during early childhood were associated with preschool myopia. Among children whose parents were myopic, the interactions between outdoor activity and fixed or mobile screen use on later preschool myopia were significant; the ORs and 95% CI were 3.34 (1.19–9.98) and 3.04 (1.06–9.21), respectively. Our findings suggest the possibility that the impact of screen exposure during early childhood on preschool myopia could be diminished by outdoor activity for children whose parents have myopia.

Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children

“…A recent meta-analysis revealed that smart device screen time alone (OR 1.26) or in combination with computer use (OR 1.77) was significantly associated with myopia in children and young adults (aged 3 months to 33 years). Huang et al reported the possibility that impact of screen exposure during early childhood on preschool myopia could be diminished by outdoor time for children whose parents have myopia ( 31 ). We therefore adjusted for age, gender, parental myopia, and screen time as well as outdoor time in our multivariate analysis.…”

“…Huang et.al. reported that exposure to fixed screen devices [adjusted odds ratio (AOR) = 2.66] and mobile screen devices (AOR = 2.66) during the early life years (1–3 years) was associated with preschool myopia ( 31 ). The World Health Organization recommends <1 h of screen time per day for preschoolers, but our results showed that 38.6% of children were exposed to more than 1 h of screen time.…”

Physical Activity Spaces Not Effective against Socioeconomic Inequalities in Myopia Incidence: The Generation R Study

“… 26 , 32 Conflicting results have been reported about household income and myopia in recently published studies. 33 , 34 Third, children from higher socioeconomic position and native Dutch children more often participate in sports than children from lower socioeconomic position and ethnic minorities in Generation R, which may result in less myopia in these groups. 12 Fourth, academic pressure from parents may be stronger in East Asian countries than in European countries as illustrated by the high prevalence of cram school attendance in East Asia.…”

A Network Analysis of Multiple Preconception Health Behaviors in Chinese Women

“…The data used in this study were collected from the Longhua Child Cohort Study (LCCS), which was a population-based child-caregiver cohort study among preschool children in the Longhua District of Shenzhen, China. The originally sampled participants were enrolled at the children's first entrance into kindergarten (three years old) and participated in follow-up assessments once a year (see Huang et al, 2021). The present study uses the retrospective preconception health behavior data from the baseline survey of the NETWORK OF PRECONCEPTION HEALTH BEHAVIORS 7 LCCS with a total of four cohorts included (2014 to 2017).…”