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早产和足月出生儿童5岁时的口颌系统评估。

Stomatognathic evaluation at five years of age in children born premature and at term.

作者信息

Guedes Kíldane Maria Almeida, Guimarães Alzira Maria D'Avila Nery, Bastos Alliny de Souza, Salviano Karoline Guedes Mesquita, Sales Neuza Josina, Almeida Maria Luiza Dória, Gurgel Ricardo Queiroz

机构信息

Graduate School of Health Sciences, Federal University of Sergipe, Aracaju, Brazil.

Center of Postgraduate Medicine, PhD Sciences of the Federal University of Sergipe, Aracaju, Brazil.

出版信息

BMC Pediatr. 2015 Mar 29;15:27. doi: 10.1186/s12887-015-0343-6.

Abstract

BACKGROUND

The high frequency of alterations of the stomatognathic system associated with premature birth may suggest that prematurity is an important risk factor in the development of this system. Prematurity has an incidence between 6-11% of births and is associated with factors such as genetic, maternal conditions (obstetric problems, nutritional status, infections) and antenatal care. In addition, undesirable situations, such as changes in enamel and the development of the skeletal structure, also appears to be associated with prematurity. This study aimed to look for changes in the stomatognathic system at five years of age associated with premature birth.

METHODS

We estimated the prevalence of developmental disorders of the stomatognathic system in the primary dentition of preschool children at five years of age. Changes in preterm infants (n = 32) compared with term born (n = 381) were evaluated . Clinical examinations and questionnaire with sociodemographic and health of mothers and children information. Gestational age, birth weight, head circumference, Apgar score and mechanical ventilation, were collected from the medical records to birth records. The explanatory variable was preterm (<37 weeks gestational age).

RESULTS

Prevalence of 7.7% of preterm infants was found. Of these, 40.6% had atresic palate, 56.2% malocclusion and 21.8% enamel hypoplasia. Forty (9.6%) children were not breastfed at the breast, and 26 (65.0%) had some type of malocclusion, showing association between not breastfeeding with an abnormal development of the stomatognathic system. The group of preterm infants showed five times more changes in head circumference and three times more mechanical ventilation use at birth. Change in head circumference at birth and mechanical ventilation has a significant association between groups of preterm and term infants.

CONCLUSIONS

Mechanical ventilation at birth directly contributed to an increased risk of developmental disorders of the stomatognathic system in preterm infants, especially dental hypoplasia. Non-breastfed children had a higher risk of developing malocclusion. Alterations in head circumference were related effective on dental malocclusion. The results suggest that changes in the stomatognathic system are influenced by premature birth and points to the imperative need of using methods of preventive.

摘要

背景

与早产相关的口颌系统改变频率较高,这可能表明早产是该系统发育的一个重要危险因素。早产发生率在出生总数的6%-11%之间,与遗传、母亲状况(产科问题、营养状况、感染)及产前护理等因素有关。此外,诸如牙釉质变化和骨骼结构发育等不良情况似乎也与早产有关。本研究旨在探寻五岁时与早产相关的口颌系统变化。

方法

我们评估了五岁学龄前儿童乳牙列中口颌系统发育障碍的患病率。对32名早产儿与381名足月儿的变化进行了评估。进行临床检查并采用包含母亲和儿童社会人口学及健康信息的问卷。从病历至出生记录收集胎龄、出生体重、头围、阿氏评分及机械通气情况。解释变量为早产(胎龄<37周)。

结果

发现早产儿患病率为7.7%。其中,40.6%有腭裂,56.2%有咬合不正,21.8%有牙釉质发育不全。40名(9.6%)儿童未进行母乳喂养,其中26名(65.0%)有某种类型的咬合不正,表明未母乳喂养与口颌系统异常发育之间存在关联。早产儿组出生时头围变化多出五倍,机械通气使用多出三倍。出生时头围变化及机械通气在早产和足月儿组之间存在显著关联。

结论

出生时机械通气直接导致早产儿口颌系统发育障碍风险增加,尤其是牙釉质发育不全。未母乳喂养的儿童患咬合不正的风险更高。头围改变与牙列咬合不正有效相关。结果表明口颌系统变化受早产影响,并指出迫切需要采用预防方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73be/4461977/a79577944eeb/12887_2015_343_Fig1_HTML.jpg

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