Influence of Maternal Prenatal Vitamin D Status on Infant Oral Health

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III. Multivariate Regression Analysis for ECC and Caries Rate The final section <strong>of</strong> this chapter examined regression relationships between independent variables collected from both prenatal and infant stages <strong>of</strong> this longitudinal cohort study and the dependent outcomes <strong>of</strong> ECC and caries tooth rates (dt). Because <strong>of</strong> the small sample size <strong>of</strong> maternal-infant dyads returning to complete this longitudinal study, several separate logistic regression models were constructed. One model explored the relationship between ECC in infants and serum metabolites <strong>of</strong> mothers during pregnancy, when primary teeth begin to develop and calcify. Other models included several well known risk factors for ECC such as the presence <strong>of</strong> enamel hypoplasia, age <strong>of</strong> the child, household employment, and infant feeding practices. Table 5.13 reports results from a logistic regression analysis performed for ECC that only examined the serum metabolites <strong>of</strong> 25(OH)D, calcium, alkaline phosphatase, and phosphorus that were obtained from women during pregnancy. Results from this small model suggested no particular association between these four metabolites with the presence <strong>of</strong> ECC in infants. However, backwards logistic regression for ECC with these same variables was performed. Results <strong>of</strong> this model (not shown) revealed that 25(OH)D was the only metabolite remaining in the last iteration <strong>of</strong> the model as it approached the threshold <strong>of</strong> being statistically significant with ECC (p=.063). 5-14
Table 5.13 – Logistic regression for ECC* (excluding white spot lesions) – Serum metabolites <strong>of</strong> alkaline phosphatase, calcium, phosphorus, and 25(OH)D Variable Regression Standard Standard Adjusted ± 95% P value Coefficient (b) Error b Deviation <strong>of</strong> Variable in Sample Odds Ratio Confidence Interval Alkaline -0.001 0.005 51.79 0.95 0.36, 0.99 .81 Phosphatase Calcium -2.06 2.36 0.10 0.81 0.49, 1.29 .38 Phosphorus -0.76 1.22 0.19 0.86 0.24, 0.61 .53 25(OH)D -0.016 0.009 24.44 0.67 0.55, 1.36 .088 *ECC reference = yes R 2 = 4.2% Another regression model was constructed to explore the associations between factors influencing endogenous synthesis and exogenous attainment <strong>of</strong> vitamin D and ECC. This model included milk and margarine intakes during pregnancy, frequency <strong>of</strong> prenatal vitamins use, season <strong>of</strong> blood sample collection, and the administration <strong>of</strong> vitamin D drops to the child during infancy (Table 5.14). Results revealed that only milk consumption was significantly associated with ECC with frequent milk intake reducing the risk for ECC (p=.024). This was also confirmed through backwards logistic regression as drinking milk was the only variable remaining in the final iteration <strong>of</strong> the model and was significantly associated with ECC (p=.026) (data not shown). 5-15
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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
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Delayed Tooth Eruption Vita
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Description of Pop
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Influence
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D has an effect on the dentition, p
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14. Utiger RD. The need for more vi
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42. Spiller WF, Jr. A clinical eval
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67. Itota T, Tashiro Y, Torii Y, Ni
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95. Bruszt P. Kariesuntersuchungen
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121. Seow WK, Needleman HL, Holm IA
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Chapter 2 - Methods for a Prospecti
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Each participant also completed an
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Table 2.2 - Recognized case definit
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Population The target population fo
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allowed the project to suffer some
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women of limited m
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involving the surface of</s
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and training cup. In addition, each
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The questionnaire was administered
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statistics including frequencies an
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elationship between the two. Poisso
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References 1. Combs GF. Vit
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27. Seow WK, Amaratunge A, Bennett
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Table 3.2 - Self-declared heritage
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Question Number Valid % Do you take
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Maternal Awareness
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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
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
Page 190 and 191: Table 5.12(a) - Logistic regression
Page 194 and 195: Table 5.14 - Logistic regression fo
Page 200 and 201: Table 5.19(b) - Backwards logistic
Page 202 and 203: Table 5.20(a) - Logistic regression
Page 204 and 205: Table 5.21 - Poisson regression for
Page 206 and 207: If enamel hypoplasia is present and
Page 208 and 209: Since maternal calcium levels were
Page 210 and 211: vitamin D deficiency, and rickets)
Page 212 and 213: to obtain it. Health literacy may b
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Page 218 and 219: hormone, calcium absorption and bon
Page 220 and 221: important nutrient. For many, this
Page 222 and 223: this potential relationship with ac
Page 224 and 225: genetic conditions, childhood medic
Page 226 and 227: vitamin D status including milk int
Page 228 and 229: y cariogenic oral flora. 49 Since e
Page 230 and 231: (49.8 ± 26.3 nmol/L vs. 45.1 ± 20
Page 232 and 233: pregnancy, which may have influence
Page 234 and 235: observed and it allowed multiple ou
Page 236 and 237: scientific evidence linking prenata
Page 238 and 239: cognizant that children who undergo
Page 240 and 241: 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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