Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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and training cup. In addition, each mother was asked when solid foods were introduced to the child and the frequency <strong>of</strong> sugary snacks. The final section <strong>of</strong> the follow-up questionnaire included variables such as the number <strong>of</strong> people in the home, whether the mother participated in “Healthy Baby” community programming, received the “Healthy Baby” provincial benefit during pregnancy, and received government assistance. Implementation Women seeking prenatal care at various core area community health clinics were invited to participate. Sites serving as centers for the recruitment <strong>of</strong> study volunteers included the Outpatient Department <strong>of</strong> Women’s Hospital, Health Action Centre, and Mount Carmel Clinic. Women’s Hospital is situated at 735 NotreDame Avenue and is part <strong>of</strong> Winnipeg’s Health Sciences Centre (HSC). Health Action Centre, a primary health clinic in the Downtown neighbourhood <strong>of</strong> Winnipeg, is situated at 425 Elgin Avenue and is also affiliated with HSC. Mount Carmel Clinic, another primary health clinic in the Point Douglas community <strong>of</strong> Winnipeg, is situated at 886 Main Street. All three clinics are known to serve many members <strong>of</strong> the Aboriginal population. The sample for this proposed research was obtained through contacts made by primary care obstetricians and family physicians, prenatal nurses, clinic staff, and other health pr<strong>of</strong>essionals providing prenatal care at these clinics. The recruitment <strong>of</strong> research participants commenced during the summer <strong>of</strong> 2002. The first participant was recruited from Health Action Centre in June 2002. The first participant from the Women’s Outpatient Department (OPD) <strong>of</strong> Health Sciences Centre 2-15
was recruited in July <strong>of</strong> that same year, while recruitment began in September 2002 at Mount Carmel Clinic. Participants were recruited by either existing clinical staff, including nursing staff, physicians, or clerical team members during one <strong>of</strong> the prenatal care visits, or by the principal investigator (PI) who was present at the site. Informed consent was obtained by clinic staff at the two primary health clinic sites (Mount Carmel Clinic and Health Action Centre) while the PI obtained informed consent from all participants at the Women’s OPD. Recruitment into this study closed January 2005. Serum sampling was utilized to assess prenatal circulating levels <strong>of</strong> 25(OH)D, calcium, phosphorus, and alkaline phosphatase. Blood samples were drawn by the hospital phlebotomist, the primary care physician, or clinic nurse. The selected period for serum collection was during the second trimester <strong>of</strong> pregnancy and was planned to coincide with routine prenatal serum screenings to minimize needless punctures. However, in some instances, serum sampling was obtained from participants during the early portion <strong>of</strong> the third trimester. Serum analysis was conducted by the Department <strong>of</strong> Clinical Chemistry, HSC. Analysis included 25(OH)D, total serum calcium, inorganic phosphorus, and alkaline phosphatase (Table 2.4). A preprinted laboratory requisition form was created to facilitate this process. Specimens were forwarded to the laboratory via current transportation and courier arrangements already established between the laboratory and participating health centres. Laboratory reports were forwarded to Dr. Michael E.K. M<strong>of</strong>fatt to keep the principal investigator blinded to each participant’s 25(OH)D status. For ethical reasons, primary physicians were contacted by Dr. M<strong>of</strong>fatt when a participant’s 25(OH)D concentrations was below 25 nmol/L. 2-16
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Influence
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Abstract Influence
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Acknowledgements This longitudinal
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Table of Contents
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Status and Non-<st
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Table 1.1-1 - Recent studies report
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Table 1.1-2 - Previous used terms f
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The Link Between Enamel Hypoplasia
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If enamel hypoplasia results from n
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malocclusions. 145 Additional human
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Daily intakes of v
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13. Milnes AR, Rubin CW, Karpa M, T
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40. Definition of
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71. Watt RG. From victim blaming to
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97. Fearne JM, Bryan EM, Elliman AM
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124. Burt BA, Pai S. Does low birth
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151. Tinanoff N, D
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Section 2 - Risk Factors for Enamel
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correspond to the timing of
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een published. 3,4,17,19 The intent
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Table 1.2-2 - Risk factors for DDE
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Opacity 51 Implicated Risk Developm
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Implicated Risk Factor Factors asso
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o Metabolic Abnormalities and Healt
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12 months of life.
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Other Factors Some uncommon risk fa
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devastating problem of</str
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13. An epidemiological index <stron
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54. Seow WK, Perham S. Enamel hypop
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82. Berdal A, Papagerakis P, Hotton
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Vitamin D may be d
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have been used to prof</str
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health’. In addition, articles we
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36 month trial had ended. 45 The nu
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Recently, a cross-sectional study <
Page 72 and 73: andomized, placebo-controlled study
Page 74 and 75: Further, amelogenin and enamelin, p
Page 76 and 77: A study of Austral
Page 78 and 79: Both dietary interventions and supp
Page 80 and 81: incidence of carie
Page 82 and 83: important nutrient. However, many <
Page 84 and 85: caries, and more hardening
Page 86 and 87: controls. 106 Interestingly, childr
Page 88 and 89: A few years later, additional resea
Page 90 and 91: Delayed Tooth Eruption Vita
Page 92 and 93: Description of Pop
Page 94 and 95: Influence
Page 96 and 97: D has an effect on the dentition, p
Page 98 and 99: 14. Utiger RD. The need for more vi
Page 100 and 101: 42. Spiller WF, Jr. A clinical eval
Page 102 and 103: 67. Itota T, Tashiro Y, Torii Y, Ni
Page 104 and 105: 95. Bruszt P. Kariesuntersuchungen
Page 106 and 107: 121. Seow WK, Needleman HL, Holm IA
Page 108 and 109: Chapter 2 - Methods for a Prospecti
Page 110 and 111: Each participant also completed an
Page 112 and 113: Table 2.2 - Recognized case definit
Page 114 and 115: Population The target population fo
Page 116 and 117: allowed the project to suffer some
Page 118 and 119: women of limited m
Page 120 and 121: involving the surface of</s
Page 124 and 125: The questionnaire was administered
Page 126 and 127: statistics including frequencies an
Page 128 and 129: elationship between the two. Poisso
Page 130 and 131: References 1. Combs GF. Vit
Page 132 and 133: 27. Seow WK, Amaratunge A, Bennett
Page 134 and 135: Table 3.2 - Self-declared heritage
Page 136 and 137: Question Number Valid % Do you take
Page 138 and 139: Maternal Awareness
Page 140 and 141: time of recruitmen
Page 142 and 143: Table 3.6- Prenatal</strong
Page 144 and 145: A total of 77 care
Page 146 and 147: indicated that they were receiving
Page 148 and 149: and 11 hypoplasia). DDEs were also
Page 150 and 151: Caries rates for children in this p
Page 152 and 153: Table 3.12 - Frequency of</
Page 154 and 155: Chapter 4 - Results: Associations <
Page 156 and 157: II. Relationship Between 25(OH)D Le
Page 158 and 159: Pregnancy & Health Prof</st
Page 160 and 161: The frequency of v
Page 162 and 163: did not (42.9 ± 21.2 nmol/L vs. 49
Page 164 and 165: Early Childhood Caries (ECC) Pr<str
Page 166 and 167: likely to have vitamin D levels at
Page 168 and 169: did not statistically differ from v
Page 170 and 171: Figure 4.4 - Predicted number <stro
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Table 4.7 - Relationship between ds
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frequently, and less likely to have
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health as average or poor, and more
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tail (p=.034) suggesting that early
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The next series of
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Results from the second model appea
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Table 5.6 - Multiple regression sta
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vitamin D. However, it did suggest
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significant at the bivariate level
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Table 5.12(a) - Logistic regression
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III. Multivariate Regression Analys
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Table 5.14 - Logistic regression fo
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Table 5.19(b) - Backwards logistic
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Table 5.20(a) - Logistic regression
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Table 5.21 - Poisson regression for
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If enamel hypoplasia is present and
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Since maternal calcium levels were
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vitamin D deficiency, and rickets)
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to obtain it. Health literacy may b
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vitamin D from the diet as dietary
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home environment can be determinant
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hormone, calcium absorption and bon
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important nutrient. For many, this
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this potential relationship with ac
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genetic conditions, childhood medic
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vitamin D status including milk int
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y cariogenic oral flora. 49 Since e
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(49.8 ± 26.3 nmol/L vs. 45.1 ± 20
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pregnancy, which may have influence
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observed and it allowed multiple ou
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scientific evidence linking prenata
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cognizant that children who undergo
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preventive program would need to be
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makers in the formative stages. As
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Surprisingly, the final regression
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13. First Nations IaMHCCPS. <strong
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38. Hollis BW. Circulating 25-hydro
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65. Li Y, Navia JM, Bian JY. Caries
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91. Brownell MD, Guevremont A, Au W
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Chapter 7 - Conclusions This thesis
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This study provided an interesting
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esiding in disadvantaged communitie
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If you are taking vitamins during t
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Do you Eat? Never Rarely (less than
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What problems can early childhood c
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Prenatal Nutrition
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Did you ever add sugar to the bottl
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Enamel Hypoplasia Enamel Hypoplasia
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Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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