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Article(id=1241036338217145294, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202412325, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1734624000000, receivedDateStr=2024-12-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815720370, onlineDateStr=2026-03-18, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815720370, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815720370, creator=13701087609, updateTime=1773815720370, updator=13701087609, issue=Issue{id=1241036327177744706, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='17', pageStart='3073', pageEnd='3264', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815717738, creator=13701087609, updateTime=1773840080282, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241138511152206262, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241138511152206263, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3160, endPage=3165, ext={EN=ArticleExt(id=1241036339886478324, articleId=1241036338217145294, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between self-reported myopia prevalence and parental reproductive age in middle school students, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between self-reported myopia prevalence and parental reproductive age in middle school students.

Methods

A questionnaire survey was conducted among 1 485 students from 11 junior/senior high schools in Tong’an District, Xiamen through multistage cluster sampling, which was used to collect information on the characteristics of the students and their parents, as well as self-reported vision. Logistic regression models were used to analyze the relationship between parental reproductive age, parental vision and self-reported myopia prevalence in middle school students.

Results

The self-reported myopia prevalence of middle school students was 80.4%. Among the students whose parental reproductive age was ≥40 years, the self-reported myopia prevalence was higher, which accounted for 84.2% and 83.2%, respectively (P<0.05). After adjusting for covariates, compared with students whose parental reproductive age was <20 years, the middle school students in groups of fathers aged 30-39 years (OR=2.04, 95% CI: 1.02-4.10) and ≥40 years (OR=2.18, 95% CI: 1.04-4.60), and mothers aged 30-39 years (OR=3.41, 95% CI: 1.83-6.36) and ≥40 years (OR=3.44, 95% CI: 1.66-7.12) had a higher risk of self-reported myopia. Among the students whose maternal reproductive age was 30-39 years, the risk of self-reported myopia increased with an increase in paternal reproductive age (P<0.05). When neither parent was myopic, the risk of self-reported myopia among students increased in the groups of fathers aged 30-39 years (OR=3.34, 95% CI: 1.35-8.49), ≥40 years (OR=3.93, 95% CI: 1.48-10.44), and mothers aged 20-29 years (OR=2.70, 95% CI: 1.33-5.49), 30-39 years (OR=3.04, 95% CI: 1.43-6.47), and ≥40 years (OR=3.93,95% CI: 1.63-9.49). When either parent was myopic, the differences in self-reported myopia risk were not statistically significant across different parental reproductive ages.

Conclusion

Advanced parental reproductive age is associated with an increased risk of self-reported myopia among middle school students, particularly in those with both parents being non-myopic. It is necessary to pay more attention to the prevention and control of myopia of middle school students with older parental reproductive age.

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目的

探讨中学生自报告近视率与父母生育年龄的关系。

方法

用多阶段整群抽样方法对厦门市同安区11所初/高中学校1 485名学生进行问卷调查，收集中学生及其父母特征和自报告视力等信息。用logistic回归模型分析父母生育年龄和父母视力与中学生自报告近视率的关系。

结果

中学生的自报告近视率为80.4%，当父、母生育年龄≥40岁时，中学生自报告近视率较高，分别为84.2%、83.2%（P<0.05）。控制协变量后，与生育年龄<20岁相比，父亲生育年龄为30～39岁(OR=2.04，95%CI:1.02～4.10)、≥40岁(OR=2.18，95%CI:1.04～4.60)以及母亲生育年龄为30～39岁(OR= 3.41，95%CI:1.83～6.36)、≥40岁(OR=3.44，95%CI:1.66～7.12)中学生自报告近视风险较高；当母亲生育年龄为30～39岁时，中学生自报告近视风险随父亲生育年龄的增加而升高（P<0.05）。当父母均不近视时，父亲生育年龄30～39组（OR=3.34，95%CI:1.35～8.49）、≥40岁组（OR=3.93，95%CI:1.48～10.44）以及母亲生育年龄20～29岁组（OR=2.70，95%CI:1.33～5.49）、30～39组（OR=3.04，95%CI:1.43～6.47）、≥40岁组（OR=3.93，95%CI:1.63～9.49）各组中学生自报告近视风险升高；当父母任一方近视时，不同生育年龄父母中学生自报告近视风险差异无统计学意义。

结论

父母生育年龄越大，中学生自报告近视风险越大，尤其在父母均不近视的群体中，应重点关注父母生育年龄较大中学生的近视防控。

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林军，E-mail:；
苏宗毅，E-mail:。
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=vrE13C6cj1/duHr8VypF2Q==, magXml=MWnCy6vCYTlUB14llQhAsQ==, pdfUrl=null, pdf=5ER+tNZErRpTbhLRo5iJ1Q==, pdfFileSize=552484, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=XGWQdkTlaKhC5smX01IJoQ==, mapNumber=null, authorCompany=null, fund=null, authors=

林军和苏宗毅为共同通信作者

林思婷（1990—），女，硕士，主管医生，研究方向：学校卫生

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PLOS One, 2023, 18(9): e0291470., articleTitle=Global risk factor analysis of myopia onset in children: A systematic review and meta-analysis, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241139370569298836, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, xref=1., ext=[AuthorCompanyExt(id=1241139370573493141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, companyId=1241139370569298836, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Kaiyuan Street Community Health Service Center, Siming District, Xiamen, Fujian 361000, China), AuthorCompanyExt(id=1241139370577687446, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, companyId=1241139370569298836, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.厦门市思明区开元街道社区卫生服务中心，福建 厦门 361000)]), AuthorCompany(id=1241139370661573531, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, xref=2., ext=[AuthorCompanyExt(id=1241139370669962140, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, companyId=1241139370661573531, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.福州眼科医院，福建 福州 350000)]), AuthorCompany(id=1241139370745459621, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, xref=3., ext=[AuthorCompanyExt(id=1241139370762236839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, companyId=1241139370745459621, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.厦门市杏林医院，福建 厦门 361000)])], figs=[ArticleFig(id=1241139374574858327, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=EN, label=Table 1, caption=

The prevalence of self-reported myopia among middle school students with different characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数（%）自报告近视χ2值P值
人数率（%）
年级初中773（54.3）56573.157.2<0.001
高中650（45.7）57989.1
性别男607（42.7）45975.615.3<0.001
女816（57.3）68583.9
居住地农村883（62.1）70479.70.70.419
城镇540（37.9）44081.5
外来务工人员子女是632（44.4）49177.75.30.022
否791（55.6）65382.6
家庭经济差104（7.3）8379.81.50.483
中125（88.3）1 01480.7
好63（ 4.4）4774.6
独生子女否114（80.6）90879.25.70.017
是276（19.4）23685.5
出生季节春季315（22.1）25280.02.40.498
夏季330（23.2）27483.0
秋季363（25.5）29280.4
冬季415（29.2）32678.6
是否与父母同住与父母或任一方同住1 383（97.2）1 10880.12.40.121
不与父母同住40（2.8）3690.0
父亲近视否1 048（73.6）78574.976.0<0.001
是375（26.4）35995.7
母亲近视否1 047（73.6）80276.636.2<0.001
是376（26.4）34291.0
父亲文化程度初中及以下850（59.7）66578.26.90.032
高中或中专418（29.4）34682.8
大专及以上155（10.9）13385.8
母亲文化程度初中及以下952（66.9）76179.90.50.797
高中或中专348（24.5）28481.6
大专及以上123（8.6）9980.5
父亲生育年龄（岁）<2049（3.4）3367.39.80.020
20～29691（48.6）54478.7
30～39449（31.6）37082.4
≥40234（16.4）19784.2
母亲生育年龄（岁）<2060（4.2）3456.723.5<0.001
20～29838（58.9）67580.5
30～39388（27.3）32182.7
≥40137（9.6）11483.2
户外运动时间（h/d）≥2221（15.5）15369.220.7<0.001
<21 202（84.5）99182.4
睡眠时间（h/d）≥8671（47.2）50475.122.5<0.001
<8752（52.8）64085.1
视屏时间（h/d）<5230（16.2）16370.915.8<0.001
≥5119（83.8）98182.2
合计1 423（100.0）1 14480.4
), ArticleFig(id=1241139374713270373, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=CN, label=表1, caption=

不同特征中学生的自报告近视情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数（%）自报告近视χ2值P值
人数率（%）
年级初中773（54.3）56573.157.2<0.001
高中650（45.7）57989.1
性别男607（42.7）45975.615.3<0.001
女816（57.3）68583.9
居住地农村883（62.1）70479.70.70.419
城镇540（37.9）44081.5
外来务工人员子女是632（44.4）49177.75.30.022
否791（55.6）65382.6
家庭经济差104（7.3）8379.81.50.483
中125（88.3）1 01480.7
好63（ 4.4）4774.6
独生子女否114（80.6）90879.25.70.017
是276（19.4）23685.5
出生季节春季315（22.1）25280.02.40.498
夏季330（23.2）27483.0
秋季363（25.5）29280.4
冬季415（29.2）32678.6
是否与父母同住与父母或任一方同住1 383（97.2）1 10880.12.40.121
不与父母同住40（2.8）3690.0
父亲近视否1 048（73.6）78574.976.0<0.001
是375（26.4）35995.7
母亲近视否1 047（73.6）80276.636.2<0.001
是376（26.4）34291.0
父亲文化程度初中及以下850（59.7）66578.26.90.032
高中或中专418（29.4）34682.8
大专及以上155（10.9）13385.8
母亲文化程度初中及以下952（66.9）76179.90.50.797
高中或中专348（24.5）28481.6
大专及以上123（8.6）9980.5
父亲生育年龄（岁）<2049（3.4）3367.39.80.020
20～29691（48.6）54478.7
30～39449（31.6）37082.4
≥40234（16.4）19784.2
母亲生育年龄（岁）<2060（4.2）3456.723.5<0.001
20～29838（58.9）67580.5
30～39388（27.3）32182.7
≥40137（9.6）11483.2
户外运动时间（h/d）≥2221（15.5）15369.220.7<0.001
<21 202（84.5）99182.4
睡眠时间（h/d）≥8671（47.2）50475.122.5<0.001
<8752（52.8）64085.1
视屏时间（h/d）<5230（16.2）16370.915.8<0.001
≥5119（83.8）98182.2
合计1 423（100.0）1 14480.4
), ArticleFig(id=1241139374881042541, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=EN, label=Table 2, caption=

Results of logistic regression analysis between self-reported myopia prevalence and parental reproductive age in middle school students

, figureFileSmall=null, figureFileBig=null, tableContent=
因素OR(95%CI）P*值
父亲生育年龄（岁）
<201
20～291.55(0.80～3.04)0.200
30～392.04(1.02～4.10)0.044
≥402.18(1.04～4.60)0.040
母亲生育年龄（岁）
<201
20～293.02（1.69～5.40）<0.001
30～393.41（1.83～6.36）<0.001
≥403.44（1.66～7.12）0.001
), ArticleFig(id=1241139374969122935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=CN, label=表2, caption=

中学生自报告近视率与父母生育年龄的logistic回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
因素OR(95%CI）P*值
父亲生育年龄（岁）
<201
20～291.55(0.80～3.04)0.200
30～392.04(1.02～4.10)0.044
≥402.18(1.04～4.60)0.040
母亲生育年龄（岁）
<201
20～293.02（1.69～5.40）<0.001
30～393.41（1.83～6.36）<0.001
≥403.44（1.66～7.12）0.001
), ArticleFig(id=1241139375065591936, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=EN, label=Table 3, caption=

Results of logistic regression analysis by cross-grouping between self-reported myopia prevalence and parental reproductive age in middle school students ［OR（95% CI）］

, figureFileSmall=null, figureFileBig=null, tableContent=
父亲生育年龄（岁）母亲生育年龄（岁）
<2020～2930～39≥40P趋势
<201.02.19(0.37～12.91)2.79(0.17～46.77)7.23(0.49～107.78)0.313
20～291.18(0.23～6.12)4.51(0.99～20.60)4.38(0.93～20.52)1.77(0.18～17.47)0.128
30～393.17(0.40～25.28)5.36(1.15～25.00)6.46(1.30～32.15)3.99(0.79～20.25)0.660
≥405.08(0.34～76.58)4.08(0.84～19.81)7.30(1.35～39.48)9.21(1.60～52.90)0.204
P 趋势0.9180.4830.0470.518
), ArticleFig(id=1241139375191421067, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=CN, label=表3, caption=

中学生自报告近视率与父母亲生育年龄交叉分组的logistic回归结果［OR（95%CI）］

, figureFileSmall=null, figureFileBig=null, tableContent=
父亲生育年龄（岁）母亲生育年龄（岁）
<2020～2930～39≥40P趋势
<201.02.19(0.37～12.91)2.79(0.17～46.77)7.23(0.49～107.78)0.313
20～291.18(0.23～6.12)4.51(0.99～20.60)4.38(0.93～20.52)1.77(0.18～17.47)0.128
30～393.17(0.40～25.28)5.36(1.15～25.00)6.46(1.30～32.15)3.99(0.79～20.25)0.660
≥405.08(0.34～76.58)4.08(0.84～19.81)7.30(1.35～39.48)9.21(1.60～52.90)0.204
P 趋势0.9180.4830.0470.518
), ArticleFig(id=1241139375325638812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=EN, label=Table 4, caption=

Results of logistic regression analysis between self-reported myopia prevalence and reproductive age among middle school students stratified by parental vision ［OR（95% CI）］

, figureFileSmall=null, figureFileBig=null, tableContent=
生育年龄（岁）父母视力
父母均不近视父母之一近视父母均近视
父亲<20111
20～292.40（0.98～5.92）1.93（0.17～21.76）2.49（0.27～22.65）
30～393.34（1.35～8.49）1.95（0.17～22.16）20.56（0.88～480.07）
≥403.93（1.48～10.44）1.83（0.13～25.08）1.08（0.09～12.86）
P趋势0.0030.8710.813
母亲<20111
20～292.70（1.33～5.49）2.72（0.39～19.04）5.25（0.23～120.04）
30～393.04（1.43～6.47）2.75（0.33～23.00）14.31（0.37～559.67）
≥403.93（1.63～9.49）1.14（0.12～11.09）3.50（0.10～128.65）
P趋势0.0130.7210.595
), ArticleFig(id=1241139375426302123, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338217145294, language=CN, label=表4, caption=

父母视力分层的生育年龄与中学生自报告近视率的logistic回归结果［OR（95%CI）］

, figureFileSmall=null, figureFileBig=null, tableContent=
生育年龄（岁）父母视力
父母均不近视父母之一近视父母均近视
父亲<20111
20～292.40（0.98～5.92）1.93（0.17～21.76）2.49（0.27～22.65）
30～393.34（1.35～8.49）1.95（0.17～22.16）20.56（0.88～480.07）
≥403.93（1.48～10.44）1.83（0.13～25.08）1.08（0.09～12.86）
P趋势0.0030.8710.813
母亲<20111
20～292.70（1.33～5.49）2.72（0.39～19.04）5.25（0.23～120.04）
30～393.04（1.43～6.47）2.75（0.33～23.00）14.31（0.37～559.67）
≥403.93（1.63～9.49）1.14（0.12～11.09）3.50（0.10～128.65）
P趋势0.0130.7210.595
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中学生自报告近视率与父母生育年龄的关系
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林思婷 1 , 林军 2 , 苏宗毅 3
现代预防医学 | 儿少卫生与妇幼保健 2025,52(17): 3160-3165
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(17): 3160-3165
中学生自报告近视率与父母生育年龄的关系
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林思婷1, 林军2 , 苏宗毅3
作者信息
  • 1.厦门市思明区开元街道社区卫生服务中心，福建 厦门 361000
  • 2.福州眼科医院，福建 福州 350000
  • 3.厦门市杏林医院，福建 厦门 361000

    • 林思婷（1990—），女，硕士，主管医生，研究方向：学校卫生

通讯作者:

林军，E-mail:；
苏宗毅，E-mail:。
Association between self-reported myopia prevalence and parental reproductive age in middle school students
Si-ting LIN1, Jun LIN2 , Zong-yi SU3
Affiliations
  • Kaiyuan Street Community Health Service Center, Siming District, Xiamen, Fujian 361000, China
出版时间: 2025-09-10 doi: 10.20043/j.cnki.MPM.202412325
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摘要
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目的

探讨中学生自报告近视率与父母生育年龄的关系。

方法

用多阶段整群抽样方法对厦门市同安区11所初/高中学校1 485名学生进行问卷调查，收集中学生及其父母特征和自报告视力等信息。用logistic回归模型分析父母生育年龄和父母视力与中学生自报告近视率的关系。

结果

中学生的自报告近视率为80.4%，当父、母生育年龄≥40岁时，中学生自报告近视率较高，分别为84.2%、83.2%（P<0.05）。控制协变量后，与生育年龄<20岁相比，父亲生育年龄为30～39岁(OR=2.04，95%CI:1.02～4.10)、≥40岁(OR=2.18，95%CI:1.04～4.60)以及母亲生育年龄为30～39岁(OR= 3.41，95%CI:1.83～6.36)、≥40岁(OR=3.44，95%CI:1.66～7.12)中学生自报告近视风险较高；当母亲生育年龄为30～39岁时，中学生自报告近视风险随父亲生育年龄的增加而升高（P<0.05）。当父母均不近视时，父亲生育年龄30～39组（OR=3.34，95%CI:1.35～8.49）、≥40岁组（OR=3.93，95%CI:1.48～10.44）以及母亲生育年龄20～29岁组（OR=2.70，95%CI:1.33～5.49）、30～39组（OR=3.04，95%CI:1.43～6.47）、≥40岁组（OR=3.93，95%CI:1.63～9.49）各组中学生自报告近视风险升高；当父母任一方近视时，不同生育年龄父母中学生自报告近视风险差异无统计学意义。

结论

父母生育年龄越大，中学生自报告近视风险越大，尤其在父母均不近视的群体中，应重点关注父母生育年龄较大中学生的近视防控。

自报告近视率  /  父母生育年龄  /  中学生
Objective

To explore the association between self-reported myopia prevalence and parental reproductive age in middle school students.

Methods

A questionnaire survey was conducted among 1 485 students from 11 junior/senior high schools in Tong’an District, Xiamen through multistage cluster sampling, which was used to collect information on the characteristics of the students and their parents, as well as self-reported vision. Logistic regression models were used to analyze the relationship between parental reproductive age, parental vision and self-reported myopia prevalence in middle school students.

Results

The self-reported myopia prevalence of middle school students was 80.4%. Among the students whose parental reproductive age was ≥40 years, the self-reported myopia prevalence was higher, which accounted for 84.2% and 83.2%, respectively (P<0.05). After adjusting for covariates, compared with students whose parental reproductive age was <20 years, the middle school students in groups of fathers aged 30-39 years (OR=2.04, 95% CI: 1.02-4.10) and ≥40 years (OR=2.18, 95% CI: 1.04-4.60), and mothers aged 30-39 years (OR=3.41, 95% CI: 1.83-6.36) and ≥40 years (OR=3.44, 95% CI: 1.66-7.12) had a higher risk of self-reported myopia. Among the students whose maternal reproductive age was 30-39 years, the risk of self-reported myopia increased with an increase in paternal reproductive age (P<0.05). When neither parent was myopic, the risk of self-reported myopia among students increased in the groups of fathers aged 30-39 years (OR=3.34, 95% CI: 1.35-8.49), ≥40 years (OR=3.93, 95% CI: 1.48-10.44), and mothers aged 20-29 years (OR=2.70, 95% CI: 1.33-5.49), 30-39 years (OR=3.04, 95% CI: 1.43-6.47), and ≥40 years (OR=3.93,95% CI: 1.63-9.49). When either parent was myopic, the differences in self-reported myopia risk were not statistically significant across different parental reproductive ages.

Conclusion

Advanced parental reproductive age is associated with an increased risk of self-reported myopia among middle school students, particularly in those with both parents being non-myopic. It is necessary to pay more attention to the prevention and control of myopia of middle school students with older parental reproductive age.

Self-reported myopia prevalence  /  Parental reproductive age  /  Middle school students
林思婷, 林军, 苏宗毅. 中学生自报告近视率与父母生育年龄的关系. 现代预防医学, 2025 , 52 (17) : 3160 -3165 . DOI: 10.20043/j.cnki.MPM.202412325
Si-ting LIN, Jun LIN, Zong-yi SU. Association between self-reported myopia prevalence and parental reproductive age in middle school students[J]. Modern Preventive Medicine, 2025 , 52 (17) : 3160 -3165 . DOI: 10.20043/j.cnki.MPM.202412325
正文
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中学生近视及高度近视引起的致盲现象已成为全社会普遍关注的公共卫生问题。据估计，到2050年，约49.8%的全球人口可能发展为近视，其中9.8%发展成高度近视[1]。近视不仅导致视力下降，影响中学生日常生活与学习，还限制一些中学毕业生的职业选择[2]，高度近视可引发一系列眼底病变，如视网膜脱离、黄斑病变等并发症，危害极大[1]。近年来，有研究表明母亲生育年龄的增加可能是近视的一大危险因素，但尚无定论，父亲生育年龄与近视之间的关系也鲜有报道[3]。既往研究表明父母近视的子代患近视的风险较高[4-5]，但父母视力状况是否影响生育年龄与子代近视风险之间的关联，目前仍缺乏实证证据。随着教育水平的提高和社会观念的改变，我国晚婚晚育现象日益突出，第七次人口普查显示，我国生育年龄结构老化，2020年育龄妇女平均生育年龄推迟至29.0岁[6]。因此，在近视人数逐年增多和平均生育年龄不断推迟的背景下分析中学生自报告近视率与父母生育年龄的关系，可为制定中学生近视防控措施提供新的见解和理论依据。
1　对象与方法
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1.1　研究对象
以厦门市同安区在读中学生为研究对象，用logistic分析方法计算本研究样本量，采用多阶段整群抽样的方法，于2020年12月—2021年1月抽取厦门市同安区6所初中校、5所高中校，在初一、初二、初三、高一、高二、高三各年级随机抽取一个班级，共抽取33个班级1 485名学生进行问卷调查。本研究通过福州眼科医院伦理委员会审查（批准号：XMYK-YK-2020-001），参与调查的学生均在问卷签署知情同意。
1.2　方法
1.2.1　问卷调查
参考信效度良好的全国学生常见病及健康危险因素监测项目组统一发放的《学生视力不良及影响因素专项调查表》[7]制定问卷，发放给所抽取的班级学生填写。利用计算机课通过问卷星发放，填写完毕后由班主任对问卷做逻辑性审核。问卷内容分为五部分：（1）中学生及其父母特征：年级、性别、居住地、是否外来务工人员子女、家庭经济、是否独生子女、出生季节、是否与父母同住、父母是否近视、父母文化程度、父母生育年龄；其中，父母生育年龄为学生出生时的父母年龄，均分为<20岁、20～29岁、30～39岁和≥40岁四组[8]；（2）户外运动时间：<2h/d、≥2h/d；（3）睡眠时间：<8h/d、≥8h/d；（4）视屏时间：<5h/d、≥5h/d；（5）自报告视力情况。通过询问学生“医生是否告知近视及两眼近视度数”获取自报告近视信息。以医生告知近视且任一眼近视度数大于等于50度判定为自报告近视[9]。
1.2.2　统计分析方法
连续型变量用（均数±标准差）表示，分类变量用百分数（%）表示。用χ2检验比较不同特征中学生的自报告近视率。采用SPSS 20.0进行统计分析，以α=0.05为检验水准。
调整年级、性别、居住地、是否外来务工人员子女、家庭经济、是否独生子女、出生季节、是否与父母同住、父母文化程度、户外运动时间、睡眠时间、视屏时间等因素，进行logistic回归分析。（1）以是否自报告近视为因变量，以父母生育年龄均<20岁组作为对照组，分别以父亲生育年龄和母亲生育年龄为自变量分析中学生自报告近视率与父母生育年龄的关联性。（2）将父亲生育年龄四组（<20岁、20～29岁、30～39岁、≥40岁）和母亲生育年龄四组（<20岁、20～29岁、30～39岁、≥40岁）交叉组合的分类变量为自变量，估算与参照组（父母生育年龄均<20岁）相比，各父母亲生育年龄组合中学生的自报告近视OR（95%CI）；固定父（母）亲为某一生育年龄组，以母（父）亲生育年龄转换为等级自变量求得P趋势，分析中学生自报告近视率随父母生育年龄变化的趋势性。（3）按父母视力（父母均不近视、父母之一近视、父母均近视）分层，分别以父母亲生育年龄为等级自变量分析其与中学生自报告近视率的关系。
2　结果
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2.1　基本情况
共发放1 485份问卷，回收有效问卷1 423份，有效回收率为95.8%。年龄在11～20岁，平均年龄为（15.7±1.8）岁。初中生773人（54.3%），女生816人（57.3%），居住于农村883人（62.1%）。父亲生育年龄在<20岁、20～29岁、30～39岁和≥40岁分别有49（3.4%）、691（48.6%）、449（31.6%）和234人（16.4%），母亲生育年龄在<20岁、20～29岁、30～39岁和≥40岁分别有60（4.2%）、838（58.9%）、388（27.3%）和137人（9.6%）。见表1。
2.2　不同特征中学生的自报告近视率
1 423名中学生的自报告近视率为80.4%，不同特征中学生的自报告近视率见表1。高中生的自报告近视率为89.1%，高于初中生的73.1%（P<0.001）；女生的自报告近视率为83.9%，高于男生的75.6%（P<0.001）；非外来务工子女、独生子女、父母近视、父亲文化程度在大专及以上、户外运动时间<2h/d、睡眠时间<8h/d、视屏时间≥5h/d的自报告近视率较高（P均小于0.05）。随着父母生育年龄的增加，中学生的自报告近视率升高（P均小于0.05），当父、母生育年龄≥40岁时，中学生自报告近视率最高，分别为84.2%、83.2%。
2.3　中学生自报告近视风险与父母生育年龄的关联的logistic回归分析
控制协变量后，与父亲生育年龄<20岁相比，父亲生育年龄为30～39岁和≥40岁时，中学生自报告近视率较高，OR(95%CI）为2.04(1.02～4.10)和2.18(1.04～4.60)；与母亲生育年龄<20岁组相比，母亲生育年龄为20～29岁、30～39岁、≥40岁时，中学生自报告近视率较高，OR(95%CI）分别为3.02（1.69～5.40）、3.41（1.83～6.36）、3.44（1.66～7.12）。见表2。
2.4　中学生自报告近视率随父母生育年龄变化的趋势性
控制协变量后，与父母生育年龄均为<20岁相比，父亲生育年龄为30～39岁且母亲生育年龄为20～29岁(OR=5.36,95%CI:1.15～25.00）、30～39岁（OR=6.46,95%CI:1.30～32.15）以及父亲生育年龄为≥40岁且母亲生育年龄为30～39岁(OR=7.30, 95%CI:1.35～39.48）、≥40岁（OR=9.21,95%CI:1.60～52.90）的中学生自报告近视风险均较高。父亲生育年龄为<20岁、20～29岁、30～39岁、≥40岁时，均未观察到中学生自报告近视风险随母亲生育年龄变化的趋势性。当母亲生育年龄为30～39岁时，中学生自报告近视风险随父亲生育年龄的增加而升高（P<0.05）。见表3。
2.5　按父母视力分层的生育年龄与中学生自报告近视关联性
控制协变量后，当父母均不近视时，中学生自报告近视风险均随父母生育年龄增加而升高（P<0.05），与生育年龄<20岁组相比，父亲生育年龄30～39组（OR=3.34,95%CI:1.35～8.49）、≥40岁组（OR=3.93,95%CI:1.48～10.44）以及母亲生育年龄20～29岁组（OR=2.70,95%CI:1.33～5.49）、30～39组（OR=3.04,95%CI:1.43～6.47）、≥40岁组（OR=3.93, 95%CI:1.63～9.49）的中学生近视风险升高，当父母任一方近视时，不同父母生育年龄中学生自报告近视率差异无统计学意义。见表4。
3　讨论
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本研究结果显示，2020年厦门市同安区中学生自报告近视率为80.4%（初中生73.1%，高中生89.1%）。数据显示该地区中学生近视率较往年有所上升，且高于同年全国水平（初中生为71.1%，高中生80.5%）[10]，横向比较可见，低于河南省[11]（85.18%），但高于河北省[12]（77.9%）和陕西省[13]（78.4%）等地。可见，2020年厦门市同安区中学生的近视防控形势严峻，不容乐观。
本研究调整了中学生及其父母特征、户外运动时间、睡眠时间、视屏时间等变量的多因素logistic回归结果显示，父母生育年龄是中学生自报告近视的危险因素。与生育年龄<20岁组相比，父亲生育年龄≥40岁、母亲生育年龄≥40岁组中学生的自报告近视风险升高。国内梁远波团队[14]通过对北京市区学生进行为期三年的队列研究发现，母亲生育年龄较大的学生，近视屈光度的变化进展得越快，尤其是母亲生育年龄>35岁时更加明显。印度学者Rohilla等人[15]发现，母亲生育年龄越大，子代近视的发病年龄提前，近视程度越严重。国外学者通过对丹麦人口的一项队列研究发现生育年龄较高的母亲的身体机能衰退，妊娠相关性疾病患病率增加，子代近视风险增高[16]。这些研究均支持了本研究中母亲生育年龄和子代近视率有关这一结论。父亲生育年龄和子代近视风险的关系尚不明确，国外学者通过发现高度近视致病基因的突变率随父亲生育年龄增加而增加，并由此推测父亲生育年龄较大的子代近视风险较高[17]，这与本研究的结果是一致的，但另有研究结果发现父亲生育年龄和子代近视率并无关联[18]，可能与高龄父亲精子DNA甲基化水平影响子代眼部发育的效应因种族或环境差异表现不同有关[17]。对于父母生育年龄增加导致子代近视风险升高的作用机制，有研究提示可能与随着父母生育年龄增加，儿童高度近视致病基因BSG突变概率增加有关[19]。另有研究显示生育年龄较大的父母文化水平及社会地位较高[18]，重视子女的学习，子女课外学习时间较多，近距离用眼时间增加，户外运动时间减少，从而近视风险增高，本研究亦发现父亲文化程度较高的中学生自报告近视率高于父亲文化程度较低的中学生，户外运动时间较长的中学生的自报告近视率高于户外运动时间较短者。
本研究发现父母近视的中学生自报告近视率较高，这与既往的研究结果一致[4-5]，多项研究均表明近视是遗传是近视的发展中不可忽视的因素。扣除父母视力的作用，本研究发现父母是否近视影响着父母生育年龄和中学生自报告近视的关系。父母生育年龄增加和中学生自报告近视风险增加的相关性仅在父母均不近视这一人群中存在。当父母均不近视时，随着父母生育年龄增高，中学生自报告近视风险升高。当父母任一方近视时，不同父母生育年龄中学生的自报告近视率无差异，提示父母近视削弱了父母生育年龄和子代自报告近视的关联性，可能是由于父母近视本身的遗传因素和环境因素对子代自报告近视的影响更为显著，从而掩盖了父母生育年龄的作用[20]。
本研究存在一定的局限性。首先，本问卷是回顾性调查，存在一定的回忆偏倚；其次是本研究的调查对象仅为厦门市同安区的中学生，且根据父母视力分层后，将父母生育年龄交叉组合后部分组别的样本量较小，限制了对父母生育年龄交叉分析的趋势性研究，未来需要更大样本验证结果；最后，本研究是横断面研究，因果关系需进一步进行前瞻性队列研究才能确定。
综上，随着父母生育年龄升高，中学生自报告近视风险增加，当父母生育年龄≥40岁时，中学生自报告近视风险最高，尤其在父母不近视时，这种关联性更明显，应重点关注父母生育年龄较大的中学生的近视防控，同时提倡制定宏观政策鼓励优生优育。
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2025年第52卷第17期
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doi: 10.20043/j.cnki.MPM.202412325
  • 接收时间：2024-12-20
  • 首发时间：2026-03-18
  • 出版时间：2025-09-10
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  • 收稿日期：2024-12-20
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    1.厦门市思明区开元街道社区卫生服务中心，福建 厦门 361000
    2.福州眼科医院，福建 福州 350000
    3.厦门市杏林医院，福建 厦门 361000

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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