Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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time <strong>of</strong> recruitment was 4.0 ± 2.2 persons. Most (92.2%) had not completed high school and only 2.3% had pursued some post-secondary education. Serum Results Serum analysis constituted an essential component <strong>of</strong> this study. Enrolled participants had serum samples drawn during pregnancy to assess circulating levels <strong>of</strong> 25(OH)D (nmol/L), total calcium (mmol/L), inorganic phosphorus (mmol/L), and alkaline phosphatase (U/L). Complete laboratory results were available for a total <strong>of</strong> 200 <strong>of</strong> the women enrolled into this study. Thus, results from seven women were missing. Some samples were lost due to delays in sending samples to the Department <strong>of</strong> Biochemistry and Genetics Laboratory or a missed venipuncture (Table 3.5). However, serum 25(OH)D was the main metabolite <strong>of</strong> interest and results were available for 200 <strong>of</strong> the women enrolled into the study. All reports were sent to one <strong>of</strong> the co-investigators (Dr. Michael M<strong>of</strong>fatt) rather than to the principal investigator in order to ensure that the primary investigator was blinded to the 25(OH)D status <strong>of</strong> the mother. This was important so as not to bias or influence the future dental examination <strong>of</strong> the infant at 12 months <strong>of</strong> age. 3-8
Table 3.5 – Frequency <strong>of</strong> participants with completed serological assays Assay Number <strong>of</strong> Participants Number Missing (%) Completed (%) 25(OH)D (nmol/L) 200 (96.6) 7 (3.4) Calcium (mmol/L) 198 (95.6) 9 (4.4) Inorganic Phosphorus 200 (96.6) 7 (3.4) (mmol/L) Alkaline Phosphatase (U/L) 199 (96.1) 8 (3.9) Table 3.6 reports mean concentrations along with their respective standard deviations (S.D.), ranges, and median values for the various metabolites <strong>of</strong> interest. The mean 25(OH)D level for the entire cohort was 48.1 ± 24.4 nmol/L (range 4.7 to 145 nmol/L) while the median value was 43.0 nmol/L. Various thresholds have been used in the scientific literature to classify 25(OH)D levels. Table 3.7 reports the distribution <strong>of</strong> participants according to these previous and current thresholds. Nearly 40% <strong>of</strong> the maternal cohort had prenatal 25(OH)D values that were in the deficient range according to reference values used by the Department <strong>of</strong> Biochemistry and Genetics Laboratory. When the current threshold proposed in the scientific literature to denote vitamin D deficiency was applied 180 participants were found to have circulating 25(OH)D levels below 80 nmol/L. 3-9
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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
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Both dietary interventions and supp
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incidence of carie
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important nutrient. However, many <
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caries, and more hardening
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controls. 106 Interestingly, childr
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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 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 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
Page 178 and 179: tail (p=.034) suggesting that early
Page 180 and 181: The next series of
Page 182 and 183: Results from the second model appea
Page 184 and 185: Table 5.6 - Multiple regression sta
Page 186 and 187: vitamin D. However, it did suggest
Page 188 and 189: 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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