Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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elationship between the two. Poisson regression was used to assess the relationship between infant caries rates (dt score) and maternal 25(OH)D levels. Multiple regression was used to identify those variables that were significantly associated with 25(OH)D levels and logistic regression analysis was performed to identify those variables strongly associated with the presence <strong>of</strong> enamel hypoplasia and ECC. Additionally, Poisson regression was also used to identify variables associated with the untreated dental caries rate (dt). Since the number <strong>of</strong> maternal-infant dyads taking part in this prospective cohort was small numerous logistic and multiple regression analyses were undertaken to prevent over-fitting <strong>of</strong> the models and avoid potential false associations. These small models for 25(OH)D were based upon themes <strong>of</strong> serum metabolites, prenatal health and health care, SES, and factors that affect endogenous and exogenous vitamin D attainment. Meanwhile, small regression models for enamel hypoplasia focused on serum metabolites, maternal awareness <strong>of</strong> calcium and vitamin D, prenatal care and diet, SES and ethnicity, and infant birth characteristics and health. Lastly, models for ECC were based upon themes <strong>of</strong> serum metabolites, factors influencing vitamin D status, infant feeding practices, SES, and dental status and dental behaviours. For continuous variables in the regression models, odds ratios and confidence intervals were calculated to reflect a change in one standard deviation unit <strong>of</strong> the variable. For instance, odds ratios for 25(OH)D and calcium reflected a one unit standard deviation change in their measure, nmol/L. 2-21
Funding Operating grants from the several agencies were awarded to conduct this research. These included the Manitoba Medical Service Foundation (University <strong>of</strong> Manitoba Grant Number 385 2339 03), the Children's Hospital Foundation <strong>of</strong> Manitoba Inc. and Manitoba Institute <strong>of</strong> Child Health, the Dentistry Canada Fund (University <strong>of</strong> Manitoba Grant Number 387 2339 02), and the Dean’s Research Funds, Faculty <strong>of</strong> Dentistry, University <strong>of</strong> Manitoba (University <strong>of</strong> Manitoba Grant Number 611 2335 31). Additional salary support for the principal investigator came in the form <strong>of</strong> Postdoctoral Fellowship funding from the Children’s Hospital Foundation <strong>of</strong> Manitoba Inc and the Manitoba Institute <strong>of</strong> Child Health. Further funding was provided through a CIHR Strategic Training Fellowship in the Canadian Child Health Clinician Scientist Program funded by the SickKids Foundation, BC Research Institute for Children and Women’s Health, and the Manitoba Institute <strong>of</strong> Child Health. 2-22
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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 <
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andomized, placebo-controlled study
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Further, amelogenin and enamelin, p
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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 122 and 123: and training cup. In addition, each
Page 124 and 125: The questionnaire was administered
Page 126 and 127: statistics including frequencies an
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
Page 172 and 173: Table 4.7 - Relationship between ds
Page 174 and 175: frequently, and less likely to have
Page 176 and 177: 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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