This project uses data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-84), linked to birth certificates for sample children ages 2-83 mo (coordinated by Dr. Overpeck through an interagency agreement with NCHS/CDC) to explore the health consequences of intrauterine growth. Completed analyses in this year focused on the effects of perinatal factors on early childhood caries (ECC). With improved survival of infants born very preterm, questions have arisen as to whether there are consequences for childhood dental development, particularly whether preterm delivery is associated with an increased risk of ECC. Information on demographic characteristics (race/ethnicity, family income), nutrition (infant feeding, childhood diet, supplements), exposure to fluoridated water, and caries status was extracted for 3,273 children, ages 3-5 years, from the Third National Health and Nutrition Examination Survey (1988-1994). These were linked to birth certificates to acquire birth weight and define degree of prematurity (very preterm <33 wk, preterm 33-36 wk, term 37+ wk); 2.2% were born very preterm, and 7.2% preterm. The main outcome variable was ECC, defined as no caries, moderate (1-7 teeth affected) and severe (8+ teeth affected). The major environmental factor related to caries, the probability of exposure to fluoridated water (public sources) at levels consistent with a protective effect (> 0.6 ppm), was estimated based on region and residential county size. As expected, exposure to fluoridated water was associated with a decrease in number of primary teeth affected with caries (-1.3 teeth affected/10% increase in probability of exposure, p<.001). Adjusting for fluoridated water exposure and other confounding, children born preterm had only a modest increased risk of ECC. However, children born very preterm had a twofold increased risk of moderate ECC (AOR=2.04, 95% CI=0.73-5.67), and a dramatically increased risk of severe ECC (AOR=11.94, 95% CI 1.16-123.07). Thus, the primary dentition of children born very preterm may be susceptible to ECC because of disruptions in tooth enamel formation or factors associated with their postnatal intensive care.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Intramural Research (Z01)
Project #
1Z01HD002512-10
Application #
6813865
Study Section
Epidemiology and Biometry Training Committee (EB)
Project Start
Project End
Budget Start
Budget End
Support Year
10
Fiscal Year
2003
Total Cost
Indirect Cost
Name
U.S. National Inst/Child Hlth/Human Dev
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Lissau, Inge; Overpeck, Mary D; Ruan, W June et al. (2004) Body mass index and overweight in adolescents in 13 European countries, Israel, and the United States. Arch Pediatr Adolesc Med 158:27-33
Luke, Barbara; Hediger, Mary L; Nugent, Clark et al. (2003) Body mass index--specific weight gains associated with optimal birth weights in twin pregnancies. J Reprod Med 48:217-24
Hediger, Mary L; Overpeck, Mary D; Ruan, W June et al. (2002) Birthweight and gestational age effects on motor and social development. Paediatr Perinat Epidemiol 16:33-46
Rao, M R; Hediger, M L; Levine, R J et al. (2002) Effect of breastfeeding on cognitive development of infants born small for gestational age. Acta Paediatr 91:267-74
Hediger, M L; Overpeck, M D; Kuczmarski, R J et al. (2001) Association between infant breastfeeding and overweight in young children. JAMA 285:2453-60
Hediger, M L; Overpeck, M D; Ruan, W J et al. (2000) Early infant feeding and growth status of US-born infants and children aged 4-71 mo: analyses from the third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr 72:159-67
Overpeck, M D; Hediger, M L; Ruan, W J et al. (2000) Stature, weight, and body mass among young US children born at term with appropriate birth weights. J Pediatr 137:205-13
Overpeck, M D; Hediger, M L; Zhang, J et al. (1999) Birth weight for gestational age of Mexican American infants born in the United States. Obstet Gynecol 93:943-7
Hediger, M L; Overpeck, M D; McGlynn, A et al. (1999) Growth and fatness at three to six years of age of children born small- or large-for-gestational age. Pediatrics 104:e33