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纯母乳喂养与幼儿牙齿疾病的关联:基于美国国家儿童健康调查的大型队列证据

Implication of Exclusive Breastfeeding in Early Childhood Dental Disorders: Large Cohort Evidence, US National Survey of Children Health.

作者信息

Holmes Laurens, Williams Janille, Thompson Neyha, John Valescia, Depeika Kerti, Ogundele Benjamin, Enwere Michael

机构信息

Global Health Equity Foundation, Bear, DE 19701, USA.

Lawhols International Scientific Research Consulting, Bear, DE 19701, USA.

出版信息

Children (Basel). 2024 Sep 30;11(10):1201. doi: 10.3390/children11101201.

Abstract

Frequent consumption of fermented carbohydrates and bottle feeding contribute to the development of early childhood caries (ECC). There are no substantial findings on the effects of breastfeeding patterns on oral health conditions in children in the United States. We aimed to assess the nexus between exclusive breastfeeding during the first 6 months and oral health disorders, namely toothache, decayed teeth, or unfilled cavities in early childhood. Cross-sectional epidemiologic design of nationally representative data collected via telephone surveys in the United States was utilized. National Survey of Children's Health, 2012 Population-based random sample of parents/guardians of 24,655 children aged 6 months to 5 years. The primary outcome was the presence of oral health disorders (OHD) in children, defined as the parent-reported occurrence of one or more of the following conditions in the past 12 months: toothache, decayed teeth, or an unfilled cavity. This was assessed through a single composite question in the survey, asking parents/guardians if their child had experienced any of these specific oral health issues within the previous year with a binary (yes/no) response option. Among 24,655 children aged 6 months to 5 years, 2392 (9.7%) had experienced an oral health disorder (OHD) in the previous 12 months. In unadjusted analysis, children exclusively breastfed for 6 months were 28% less likely to present with OHD compared to never-breastfed children (OR = 0.72, 95% CI, 0.52-0.98). However, after adjusting for key factors, including maternal health and race/ethnicity, this association was no longer statistically significant (aOR = 1.11, 95% CI 0.79-1.57). Significant predictors of OHD included maternal health (aOR for fair/poor vs. excellent/very good maternal health = 1.79, 95% CI 1.08-2.69) and race/ethnicity, with a higher prevalence among non-Hispanic Black (12.9%) and multi-racial children (12.6%) compared to non-Hispanic White children (7.7%). While exclusive breastfeeding for the first six months of life was not found to be a significant predictor of pediatric oral health outcomes after adjustment, maternal health and race/ethnicity were significant determinants of oral health disorders. These findings underscore the importance of comprehensive healthcare approaches that consider maternal well-being and socio-demographic factors. Future research should explore interventions targeting these factors to improve pediatric oral health outcomes.

摘要

经常食用发酵碳水化合物和奶瓶喂养会导致幼儿龋齿(ECC)的发生。关于母乳喂养模式对美国儿童口腔健康状况的影响,目前尚无实质性研究结果。我们旨在评估出生后头6个月纯母乳喂养与口腔健康问题之间的联系,这些问题包括牙痛、龋齿或幼儿期未填补的龋洞。我们采用了通过美国电话调查收集的具有全国代表性数据的横断面流行病学设计。2012年全国儿童健康调查,以24,655名6个月至5岁儿童的父母/监护人作为基于人群的随机样本。主要结果是儿童口腔健康问题(OHD)的存在,定义为父母报告在过去12个月内出现以下一种或多种情况:牙痛、龋齿或未填补的龋洞。这是通过调查中的一个综合问题进行评估的,询问父母/监护人他们的孩子在过去一年中是否经历过这些特定的口腔健康问题,回答选项为二元(是/否)。在24,655名6个月至5岁的儿童中,有2392名(9.7%)在过去12个月内经历过口腔健康问题(OHD)。在未调整的分析中,与从未母乳喂养的儿童相比,纯母乳喂养6个月的儿童出现OHD的可能性低28%(OR = 0.72,95% CI,0.52 - 0.98)。然而,在调整了包括母亲健康和种族/族裔等关键因素后,这种关联不再具有统计学意义(校正后OR = 1.11,95% CI 0.79 - 1.57)。OHD的重要预测因素包括母亲健康(母亲健康状况为一般/较差与优秀/非常好相比,校正后OR = 1.79,95% CI 1.08 - 2.69)和种族/族裔,与非西班牙裔白人儿童(7.7%)相比,非西班牙裔黑人儿童(12.9%)和多种族儿童(12.6%)的患病率更高。虽然在调整后未发现出生后头六个月纯母乳喂养是儿童口腔健康结果的重要预测因素,但母亲健康和种族/族裔是口腔健康问题的重要决定因素。这些发现强调了考虑母亲健康和社会人口因素的综合医疗保健方法的重要性。未来的研究应探索针对这些因素的干预措施,以改善儿童口腔健康结果。

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