Tolomeu Jéssica Samara Oliveira, Soares Maria Eliza Consolação, Mourão Priscila Seixas, Ramos-Jorge Maria Letícia
Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, Brazil.
Post-Graduate Program in Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, Brazil.
Arch Oral Biol. 2022 Sep;141:105488. doi: 10.1016/j.archoralbio.2022.105488. Epub 2022 Jun 27.
The present systematic review aimed to verify the association between Gestational Diabetes Mellitus (GDM) and Developmental Defects of Enamel (DDE) in children. Design A systematic search was conducted in four databases and the grey literature. The risk of bias of the studies was analyzed with the aid of the Newcastle-Ottawa scale. A quantitative synthesis was performed through meta-analysis. The quality of the evidence was assessed for each result using the Grading of Recommendations: Assessment, Development and Evaluation approach.
Thirteen studies (seven cross-sectional, two cohort and four case-control studies) were included in the qualitative analysis and eleven were included in the meta-analyses. Meta-analyses were conducted considering general DDE (regardless of the type of defect), hypoplasia, molar incisor hypomineralization (MIH) and hypomineralized primary second molars (HPSM). Subgroups based on the type of dentition were also analyzed. Children of mothers who had GDM presented a greater likelihood of general DDE (OR = 2.72; 95% CI: 1.66-4.44), MIH (OR = 3.14; 95% CI: 1.20-8.25) and hypoplasia (OR = 2.17; 95% CI: 1.36-3.46). No association was found between HPSM and GDM (OR = 0.60; 95% CI: 0.17-2.20). An association was found between GDM and DDE in the permanent dentition. Therefore, children whose mothers had GDM were more likely to present DDE compared to those whose mothers did not have this metabolic disorder.
The results should be interpreted with caution due to the low evidence of the primary studies.
本系统评价旨在验证妊娠期糖尿病（GDM）与儿童牙釉质发育缺陷（DDE）之间的关联。设计：在四个数据库和灰色文献中进行系统检索。借助纽卡斯尔-渥太华量表分析研究的偏倚风险。通过荟萃分析进行定量综合。使用推荐分级：评估、制定和评价方法对每个结果的证据质量进行评估。
定性分析纳入了13项研究（7项横断面研究、2项队列研究和4项病例对照研究），荟萃分析纳入了11项研究。荟萃分析针对一般DDE（不考虑缺陷类型）、发育不全、磨牙切牙矿化不全（MIH）和矿化不全的乳牙第二磨牙（HPSM）进行。还分析了基于牙列类型的亚组。患有GDM的母亲的孩子出现一般DDE（OR = 2.72；95% CI：1.66 - 4.44）、MIH（OR = 3.14；95% CI：1.20 - 8.25）和发育不全（OR = 2.17；95% CI：1.36 - 3.46）的可能性更大。未发现HPSM与GDM之间存在关联（OR = 0.60；95% CI：0.17 - 2.20）。在恒牙列中发现GDM与DDE之间存在关联。因此，与母亲没有这种代谢紊乱的孩子相比，母亲患有GDM的孩子更有可能出现DDE。
由于原始研究的证据不足，对结果的解释应谨慎。
