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Caries Experience Among Children Born After a Complicated Pregnancy
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This prospective study evaluated 5323 six-year-old Dutch children who were born with complications (small for gestational age, spontaneous preterm birth, gestational hypertension, and pre‐eclampsia) for caries in the primary dentition to determine the relationship between complicated birth and early childhood caries. The authors found no association between caries experience in the primary dentition and complicated birth.
- These findings are somewhat surprising as a complicated pregnancy can negatively affect dental development. However, only the primary dentition was assessed in this study; the first permanent molars may be most at risk given the stage of crown development during birth. Prevention remains critically important for children at an increased caries risk.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVES
Behavioural and lifestyle factors, as oral hygiene and diet, are well-established risk factors in the pathogenesis of dental caries, though displaying large differences in susceptibility across individuals. Since enamel formation already starts in utero, pregnancy course and outcome may eventually play a role in enamel strength and caries susceptibility. Therefore, we studied the association between history of pregnancy complications and the caries experience in their six-year-old children. The pregnancy complications included small for gestational age (SGA), spontaneous preterm birth (sPTB), gestational hypertension (GH), pre-eclampsia (PE), individually, and a combination of those, designated as placental syndrome.
METHODS
This study was embedded in Generation R, a prospective longitudinal Dutch multiethnic pregnancy cohort study. Information about pregnancy complications was obtained from questionnaires completed by midwives and obstetricians with cross-validation in medical records. These included SGA, sPTB, GH and PE. Caries experience was assessed with the decayed, missing and filled teeth (dmft) index at a mean age of six years. The association between dental caries experience and a history of pregnancy complications was studied by using hurdle negative binomial (HNB) models.
RESULTS
We were able to assess the dmft index in 5323 six-year-old children (mean age 6.2 years, SD 0.5). We did not find an association between the different pregnancy complications and dental caries experience in childhood, whether for SGA, sPTB, GH, PE, or for the combined outcome placental syndrome (HNB estimates: OR 1.02, 95%CI 0.87 - 1.19; RR 0.90, 95%CI 0.78 - 1.04). Further adjustment of the models with different confounders did not alter the outcome.
CONCLUSIONS
Although it is expected that prenatal stress can be a risk factor for caries development later in life, our findings do not support this hypothesis. Therefore, we believe disparities in caries experience between children are probably not explained by early life events during a critical intrauterine period of development.
Additional Info
Disclosure statements are available on the authors' profiles:
Caries Experience Among Children Born After a Complicated Pregnancy
Community Dent Oral Epidemiol 2021 Jun 01;49(3)225-231, JT van der Tas, EB Wolvius, L Kragt, F Rivadeneira, HA Moll, EAP Steegers, S Schalekamp-TimmermansFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.