Myopia is a refractive error, and in recent years, the prevalence of myopia among children and adolescents has remained high and has shown a tendency to be at a younger age, posing a great threat to the physical and mental health of children and adolescents. Currently, there are few systematic studies on myopia and risk factors in children and adolescents.

To explore the prevalence and influencing factors of myopia among children and adolescents in China using Meta-analysis.

A combination of Mesh subject terms and free terms was used to search for information on the prevalence of myopia in the databases of Web of Science, PubMed, Cochrane Library, China Knowledge Network (CNKI), Wanfang Data, VIP, and China Biomedical Literature Service System (SinoMed). Databases were searched for studies on the prevalence and influencing factors of myopia up to November 2024. The inclusion of studies was determined by consultation after independent screening by 2 investigators, and the studies were assessed for literature quality using the Agency for Healthcare Research and Quality (AHRQ) evaluation criteria, and Meta-analysis was performed using Stata 18.0 software.

A total of 33 papers were included, with 768 813 cases of myopia. Meta-analysis showed that the prevalence of myopia among children and adolescents in China was 58% (95%CI=54%-62%), with the prevalence of myopia among females (OR=1.41, 95%CI=1.21-1.64), high school (OR=3.59, 95%CI=1.17-10.97), and senior grades (OR=1.53, 95%CI=1.33-1.77), urban (OR=2.12, 95%CI=1.29-3.48), one or both parents myopic (OR=1.88, 95%CI=1.78-1.99; OR=2.45, 95%CI=1.97-3.06), overweight or obese (OR=1.74, 95%CI=1.63-1.85), and incorrect reading and writing posture (OR=1.35, 95%CI=1.14-1.60), reading books or electronic screens while lying down or lying on their stomachs (OR=1.17, 95%CI=1.03-1.33), terminal video screen use >2 h per day (OR=1.29, 95%CI=1.15-1.44), and of outdoor activity <2 h per day (OR=1.41, 95%CI=1.10-1.80), average daily sleep time ≤8 h (OR=1.71, 95%CI=1.28-2.30), and attending cultural tutorial classes for ≥2 h in the past week (OR=1.27, 95%CI=1.12-1.42) were the risk factors for myopia in children and adolescents (P<0.05) ; doing eye exercises (OR=0.79, 95%CI=0.64-0.98), preferring vegetables and fruits (OR=0.84, 95%CI=0.76-0.92), and having outdoor activities during recess (OR=0.75, 95%CI=0.74-0.77) were protective factors for myopia in children and adolescents (P<0.05) .

The prevalence of myopia among children and adolescents in China is high, and females, high school, urban, family history of myopia, obesity, eye habits and conditions, sleep time, and insufficient outdoor activities are the main risk factors for myopia among children and adolescents, which should be improved to increase the attention to myopia among children and adolescents, and to provide early identification of myopia and intervention for children and adolescents, so as to reduce the prevalence of myopia and improve the quality of life of children with myopia.

近视是一种屈光不正，近年来，儿童青少年近视患病率居高不下且呈现低龄化趋势，对儿童青少年身心健康造成极大威胁。目前，关于儿童青少年近视与危险因素的系统研究较少。

利用Meta分析探讨国内儿童青少年近视的患病率和影响因素。

采用Mesh主题词与自由词相结合的方式在Web of Science、PubMed、Cochrane Library、中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普网（VIP）、中国生物医学文献服务系统（SinoMed）数据库中检索关于儿童青少年近视患病率及影响因素的研究，检索时间截至2024年11月。由2名研究者独立筛选后协商确定纳入研究，研究采用美国医疗保健研究与质量机构（AHRQ）评价标准进行文献质量评估，采用Stata 18.0软件进行Meta分析。

共纳入文献33篇，近视儿童青少年768 813名。Meta分析结果显示，中国儿童青少年近视患病率为58%（95%CI=54%~62%），其中女性（OR=1.41，95%CI=1.21~1.64）、高中（OR=3.59，95%CI=1.17~10.97）、高年级（OR=1.53，95%CI=1.33~1.77）、城市（OR=2.12，95%CI=1.29~3.48）、父母一方或均近视（OR=1.88，95%CI=1.78~1.99；OR=2.45，95%CI=1.97~3.06）、超重或肥胖（OR=1.74，95%CI=1.63~1.85）、读写姿势错误（OR=1.35，95%CI=1.14~1.60）、躺着或趴着看书或电子屏幕（OR=1.17，95%CI=1.03~1.33）、每天终端视屏使用时间>2 h（OR=1.29，95%CI=1.15~1.44）、每天户外活动时间<2 h（OR=1.41，95%CI=1.10~1.80）、平均每天睡眠时间≤8 h（OR=1.71，95%CI=1.28~2.30）、过去1周参加文化类补习班时间≥2 h（OR=1.27，95%CI=1.12~1.42）是儿童青少年近视的危险因素（P<0.05）；而做眼保健操（OR=0.79，95%CI=0.64~0.98）、喜食蔬菜水果（OR=0.84，95%CI=0.76~0.92）、课间休息时的活动场所为户外（OR=0.75，95%CI=0.74~0.77）是儿童青少年近视的保护因素（P<0.05）。

中国儿童青少年近视患病率较高，女性、高中、城市、近视家族史、肥胖、用眼习惯及情况、睡眠时间、户外活动不足是儿童青少年近视主要危险因素，应提高对儿童青少年近视的重视程度，对儿童青少年近视进行早期识别和干预，减少近视患病率，提高患儿生活质量。