Abstract
PURPOSE: The purpose of the study was to evaluate the possible relation between the mode of delivery and associated factors with congenital nasolacrimal duct obstruction (CNLDO). METHODS: This case-control study was conducted on children between 6 months and 5 years with CNLDO and healthy controls. A binary logistic regression model was fitted to identify the associated factors with CNLDO and a backward elimination technique was applied for modeling. RESULTS: From 324 enrolled subjects, 160 were as a case (CNLDO group) and 164 were healthy control (non-CNLDO group). A positive family history of CNLDO was present in 21 (13.1%) patients with CNLDO and 3 (1.81%) controls (P < 0.001). Cesarean section was 62.9% and 64.0% in the CNLDO and controls groups, respectively (P = 0.83). Using logistic regression models, children with a positive family history were 10.12 times more likely to have CNLDO than the control group (odds ratio [OR] = 10.12, 95% confidence interval [CI] 2.838-36.069). In addition, birth weight ≤2500 g (OR = 2.39, 95% CI: (1.123-5.087)) and maternal age ≤27 years at the time of delivery (OR = 2.35, 95% CI: (1.462-3.778)) were associated with upper odds for CNLDO. CONCLUSION: There is an increase in the risk of CNLDO with a positive family history, birth weight < 2500 g, and maternal age of <27 years. However, further research is warranted to evaluate the causal relationship of these risk factors. Notably, there is no significant relationship between the mode of delivery and developing CNLDO.