Un Lam Carolina, Hsu Chin-Ying Stephen, Yee Robert, Koh David, Lee Yung Seng, Chong Mary Foong-Fong, Cai Meijin, Kwek Kenneth, Saw Seang Mei, Gluckman Peter, Chong Yap Seng
Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Clin Oral Investig. 2016 Nov;20(8):1861-1870. doi: 10.1007/s00784-015-1658-2. Epub 2015 Nov 23.
This longitudinal study aimed to investigate the prevalence of teething-related pain and fever and the early-life factors that may affect the risk of experiencing these disturbances within the first 1.5 years of life.
Participants were recruited (n = 1033) through the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 1237). Interviews were performed tri-monthly regarding the prevalence of teething pain and fever in children from 6 to 18 months of age. Crude and multivariable analyses were conducted using Poisson-log regression models.
Prevalence rates for teething pain and fever were 35.5 and 49.9 % respectively. Multivariable Poisson regression analysis showed maternal second-hand tobacco smoke (SHS) exposure to increase the risk of both pain (mean ratio = 1.35; p = 0.006) and fever (mean ratio = 1.22; p = 0.025), whereas SHS exposure plus active smoking further increased risk of teething pain in the children (mean ratio = 1.89; p = 0.029). Delivery via Caesarean section increased risk of teething pain (mean ratio = 1.27; p = 0.033), while prenatal plasma vitamin D insufficiency lowered such a risk (mean ratio = 0.62; p = 0.012). Compared to Chinese infants, Indian babies exhibited lower risk of teething pain and fever (both p ≤ 0.001).
Early-life factors such as tobacco smoke exposure and vitamin insufficiency during pregnancy, ethnicity and childbirth via Caesarean section may significantly affect the child's susceptibility to teething-related pain and fever.
Knowledge of prevalence and risk factors of teething disturbances may better equip primary caregivers and healthcare professionals to accurately detect teething-related local and/or systemic signs/symptoms and effectively facilitate tobacco cessation among pregnant women.
本纵向研究旨在调查出牙相关疼痛和发热的患病率，以及可能影响婴儿出生后1.5年内出现这些不适风险的早期生活因素。
通过新加坡迈向健康成长结局（GUSTO）出生队列（n = 1237）招募参与者（n = 1033）。每三个月对6至18个月大儿童的出牙疼痛和发热患病率进行访谈。使用泊松对数回归模型进行粗分析和多变量分析。
出牙疼痛和发热的患病率分别为35.5%和49.9%。多变量泊松回归分析显示，母亲接触二手烟会增加疼痛（平均比值 = 1.35；p = 0.006）和发热（平均比值 = 1.22；p = 0.025）的风险，而接触二手烟加主动吸烟会进一步增加儿童出牙疼痛的风险（平均比值 = 1.89；p = 0.029）。剖宫产会增加出牙疼痛的风险（平均比值 = 1.27；p = 0.033），而产前血浆维生素D不足会降低这种风险（平均比值 = 0.62；p = 0.012）。与中国婴儿相比，印度婴儿出牙疼痛和发热的风险较低（p均≤0.001）。
早期生活因素，如孕期接触烟草烟雾、维生素不足、种族以及剖宫产，可能会显著影响儿童出牙相关疼痛和发热的易感性。
了解出牙不适的患病率和风险因素，可能会使初级护理人员和医疗保健专业人员更好地准确检测出牙相关的局部和/或全身体征/症状，并有效地促进孕妇戒烟。
