da Fonseca Cumerlato Catarina Borges, Cademartori Mariana Gonzalez, Barros Fernando Celso, Dâmaso Andréa Homsi, da Silveira Mariângela Freitas, Hallal Pedro Curi, Demarco Flávio Fernando, Corrêa Marcos Britto
Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil.
Catholic University of Pelotas, Gonçalves Chaves, 373, Pelotas, RS, 96015560, Brazil.
Clin Oral Investig. 2023 Dec;27(12):7625-7634. doi: 10.1007/s00784-023-05351-1. Epub 2023 Oct 28.
The aim of this study was to investigate the effect of maternal's depression trajectory in the first 1000 days of the child's life on the prevalence of early childhood dental caries (ECC), in a birth cohort.
All infants born in Pelotas in 2015 were identified, and the mothers were invited to participate in the cohort. A total of 3645 children were included in the study. The outcome was ECC at 48 months of age assessed according to ICDAS. Maternal depression was collected using Edinburgh Postnatal Depression Scale (EPDS) antenatally, at 3, 12, and 24 months of age. Maternal depressive symptom trajectory variables were created using group-based trajectory models and adopting two cutoff points. Poisson regression model with robust variance was used to identify the total effect of maternal depressive symptom trajectories on ECC, adjusting by confounders.
A total of 29.2% of the mothers presented a high trajectory for screening of depression, and 18.8% presented a high trajectory of depression diagnosis. The prevalence of ECC was 26.7%. After adjusted analysis, maternal depression trajectories (screening and diagnosis) from pregnancy to 24 months increased the risk for ECC at 48 months of age (RR = 1.14; 95% CI 1.02-1.28 and RR = 1.19; 95% CI 1.05-1.35).
Children from mothers with high depression trajectory had higher risk of having dental caries at 48 months compared to children from mothers with low depression trajectory.
Strategies of early detection and treatment of maternal mental disorders during the Golden Period should be considered of high priority in health services since it could impact positively in children's life.
本研究旨在调查出生队列中儿童生命最初1000天内母亲的抑郁轨迹对幼儿龋齿（ECC）患病率的影响。
确定了2015年在佩洛塔斯出生的所有婴儿，并邀请其母亲参与该队列研究。共有3645名儿童纳入本研究。结局指标为根据国际龋病检测与评估系统（ICDAS）评估的48月龄时的ECC。产前、3月龄、12月龄和24月龄时使用爱丁堡产后抑郁量表（EPDS）收集母亲的抑郁情况。使用基于群组的轨迹模型并采用两个切点创建母亲抑郁症状轨迹变量。采用具有稳健方差的泊松回归模型确定母亲抑郁症状轨迹对ECC的总体影响，并对混杂因素进行校正。
共有29.2%的母亲在抑郁筛查中呈现高轨迹，18.8%的母亲在抑郁诊断中呈现高轨迹。ECC的患病率为26.7%。经过校正分析，从孕期至24月龄母亲的抑郁轨迹（筛查和诊断）增加了48月龄时患ECC的风险（风险比[RR]=1.14；95%置信区间[CI]1.02 - 1.28和RR = 1.19；95% CI 1.05 - 1.35）。
与母亲抑郁轨迹低的儿童相比，母亲抑郁轨迹高的儿童在48月龄时患龋齿的风险更高。
在黄金时期对母亲精神障碍进行早期检测和治疗的策略应在卫生服务中被视为高度优先事项，因为这可能对儿童的生活产生积极影响。
