Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

2. To determine the prevalence <strong>of</strong> enamel hypoplasia and incidence <strong>of</strong> ECC in the
primary dentition, including the maxillary incisors, <strong>of</strong> the infant as they erupt into
the oral cavity.
3. To determine the association between maternal 25(OH)D status during pregnancy
and the presence or absence <strong>of</strong> enamel hypoplasia and ECC in the primary
dentition <strong>of</strong> the infant.
Study Design
A quantitative research strategy was employed and involved women being enrolled in a
prospective cohort study during pregnancy (Figure 2.1). A serum sample from each
participant was collected during a regular prenatal visit. The collection <strong>of</strong> these samples
for the majority <strong>of</strong> participants coincided with routine prenatal blood draws. The desired
period for serum sampling was during the second trimester <strong>of</strong> pregnancy, as the maxillary
primary incisors (i.e. teeth commonly affected by ECC) begin to develop by six weeks in
utero and begin to calcify during weeks 13 and 17 in utero. However, some participants
were enrolled during the early third trimester <strong>of</strong> pregnancy.
Serum analysis was conducted for 25-hydroxyvitamin D (25(OH)D), as this is a
reliable means <strong>of</strong> assessing overall vitamin D status. 1-3 Serum analysis also included
assessments <strong>of</strong> total calcium, inorganic phosphorus, and alkaline phosphatase
concentrations. Detectable elevations in circulating serum levels <strong>of</strong> alkaline phosphatase
can be indicative <strong>of</strong> vitamin D insufficiency 4 while decreased serum phosphorus and
calcium in conjunction with parathyroid hormone stimulate the hydroxylation <strong>of</strong>
25(OH)D to 1,25-dihydroxyvitamin D (1,25(OH) 2 D 3 ), the active form <strong>of</strong> vitamin D. 5 2-2