Brandquist E, Dahllöf G, Hjern A, Julihn A
Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Pediatric Dental Clinic in Gothenburg, Public Dental Service in Västra Götaland, Sweden.
JDR Clin Trans Res. 2017 Oct;2(4):386-396. doi: 10.1177/2380084417716073. Epub 2017 Jun 19.
Caesarean section has been shown to affect the health of the child. Only a few studies have investigated whether the mode of delivery is associated with dental caries, and they present conflicting results. Our study investigated whether dental caries was associated with delivery method in Swedish preschool children. This retrospective register-based cohort study included all children born from 2000 to 2003 who were residing in Stockholm County, Sweden, at 3 y of age ( = 83,147). The study followed the cohort until individuals were 7 y of age. Children examined at 3 and 7 y constituted the final study cohort ( = 65,259). We dichotomized the key exposure "delivery starts by caesarean section" and analyzed it in univariate analyses as well as in multivariate analyses. The multivariate analyses used 3 outcomes: caries experience at age 3 (deft >0 [decayed, extracted, and filled teeth]), caries increment between 3 and 7 y of age (Δdeft > 0), and caries experience at age 7 (deft > 0). Of the final cohort, 15% ( = 9,587) were delivered by caesarean section. At 3 y of age, the results showed no statistically significant association between caesarean section and caries experience (odds ratio = 0.92, 95% confidence interval [CI] = 0.82 to 1.04). Between 3 and 7 y of age, the association of caesarean section on caries increment was 0.88 (95% CI = 0.83 to 0.94) and at 7 y of age, 0.88 (caries experience; 95% CI = 0.82 to 0.94). Higher mean values for caries experience and caries increment were observed in vaginally delivered children. We found that preschool children who were delivered by caesarean section do not represent a group with an excess risk of developing dental caries. Furthermore, the statistically significant associations with caries increment and caries experience at age 7 were negative. : Children born by caesarean section are at greater risk of developing asthma and obesity. The proportion of elective caesarean sections without a medical indication has increased over the years; therefore, it is important to know how this mode of delivery affects oral health of the child. The results show that children who are delivered by caesarean section are not at greater risk of developing dental caries, and clinicians can use these findings in their risk assessment.
剖宫产已被证明会影响儿童健康。仅有少数研究调查了分娩方式与龋齿之间是否存在关联，且这些研究结果相互矛盾。我们的研究调查了瑞典学龄前儿童的龋齿与分娩方式之间是否存在关联。这项基于登记的回顾性队列研究纳入了2000年至2003年出生、3岁时居住在瑞典斯德哥尔摩县的所有儿童（n = 83,147）。该队列随访至个体7岁。在3岁和7岁时接受检查的儿童构成了最终研究队列（n = 65,259）。我们将关键暴露因素“剖宫产开始分娩”进行二分法处理，并在单因素分析和多因素分析中对其进行分析。多因素分析使用了3个结局指标：3岁时的龋齿经历（乳牙龋失补牙面数>0[龋坏、拔除和补牙的牙齿]）、3岁至7岁之间的龋齿增加量（乳牙龋失补牙面数增量>0）以及7岁时的龋齿经历（乳牙龋失补牙面数>0）。在最终队列中，15%（n = 9,587）的儿童通过剖宫产分娩。在3岁时，结果显示剖宫产与龋齿经历之间无统计学显著关联（比值比 = 0.92，95%置信区间[CI] = 0.82至1.04）。在3岁至7岁之间，剖宫产对龋齿增加量的关联为0.88（95%CI = 0.83至0.94），在7岁时为0.88（龋齿经历；95%CI = 0.82至0.94）。经阴道分娩的儿童龋齿经历和龋齿增加量的平均值更高。我们发现，通过剖宫产分娩的学龄前儿童并非患龋齿风险更高的群体。此外，与7岁时龋齿增加量和龋齿经历的统计学显著关联为负相关。：剖宫产出生的儿童患哮喘和肥胖症的风险更高。近年来，无医学指征的选择性剖宫产比例有所增加；因此，了解这种分娩方式如何影响儿童口腔健康很重要。结果表明，剖宫产出生的儿童患龋齿的风险并不更高，临床医生可在风险评估中使用这些发现。
