Taylor Greig D
Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK.
Evid Based Dent. 2017 Mar;18(1):15-16. doi: 10.1038/sj.ebd.6401219.
Data sourcesThe Medline and Embase databases and hand searches in the journals International Journal of Paediatric Dentistry and European Archives of Paediatric Dentistry.Study selectionEnglish language cohort and case-control studies.Data extraction and synthesisStudy selection was carried out independently by two reviewers with data abstraction being conducted by a single reviewer and checked by a second reviewer. Risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). Adjusted (aOR) and unadjusted odds ratios (uOR), P-values and 95% confidence intervals (CI) were obtained from the studies. Meta-analysis was not conducted.ResultsTwenty-eight studies were included; 25 reported on MIH, three on hypomineralised second primary molars (HSPM). Nineteen of the studies were of cohort design (six prospective,13 retrospective) and nine were case controls. There was little evidence of an association between the most frequently investigated prenatal factors (smoking, maternal illness, maternal medication, maternal stress) and MIH. Similarly there was little evidence of an association between MIH and perinatal factors such as prematurity, low birth weight, caesarean delivery and birth complications. Early childhood illness, up to three or four years of age, was widely investigated, with six studies reporting a crude association. Associations between antibiotics, anti-asthma medication and breastfeeding were also evaluated. Only three studies looked at HSPM; one study suggested that maternal antibiotic use during pregnancy is unlikely to be associated with HSPM but maternal alcohol intake may be. Another study reported possible associations with a large number of factors, with perinatal factors and neonatal illness being most common, followed by prenatal factors.ConclusionsPrenatal and perinatal factors are infrequently associated with MIH. However, despite a lack of prospective studies, early childhood illness (in particular fever) appears to be associated with MIH. Further prospective studies that adjust for confounding based on biological principles, as well as genetic and epigenetic studies, are needed because the aetiology is likely to be multifactorial.
数据来源
检索了Medline和Embase数据库，并人工检索了《国际儿童牙科杂志》和《欧洲儿童牙科文献》。
研究选择
英文队列研究和病例对照研究。
数据提取与综合
研究选择由两名评审员独立进行，数据提取由一名评审员完成，并由另一名评审员进行核对。使用纽卡斯尔-渥太华量表（NOS）的修订版评估偏倚风险。从研究中获取调整后的（aOR）和未调整的比值比（uOR）、P值和95%置信区间（CI）。未进行荟萃分析。
结果
纳入了28项研究；25项报告了乳牙列发育不全（MIH），3项报告了矿化不全的第二乳磨牙（HSPM）。其中19项研究为队列设计（6项前瞻性研究，13项回顾性研究），9项为病例对照研究。几乎没有证据表明最常研究的产前因素（吸烟、母亲疾病、母亲用药、母亲压力）与MIH之间存在关联。同样，也几乎没有证据表明MIH与围产期因素如早产、低出生体重、剖宫产和出生并发症之间存在关联。对3至4岁前的儿童疾病进行了广泛研究，有6项研究报告了粗略的关联。还评估了抗生素、抗哮喘药物与母乳喂养之间的关联。只有3项研究关注HSPM；一项研究表明，孕期母亲使用抗生素不太可能与HSPM有关，但母亲饮酒可能有关。另一项研究报告了与大量因素的可能关联，围产期因素和新生儿疾病最为常见，其次是产前因素。
结论
产前和围产期因素与MIH的关联较少。然而，尽管缺乏前瞻性研究，但儿童早期疾病（尤其是发热）似乎与MIH有关。由于病因可能是多因素的，则需要基于生物学原理进行混杂因素调整的进一步前瞻性研究，以及基因和表观遗传学研究。
