79 - Fetal and Infant Growth Dynamics Linked to Early Childhood Caries

Abstract:

Purpose:
Early childhood caries (ECC) affects millions of children worldwide, yet developmental determinants of ECC risk remains unclear. This study investigated whether deviations in fetal and infant growth are associated with ECC risk.

Methods:
Among 737 children in the GUSTO birth cohort, changes in fetal abdominal circumference (ΔFAC z-score) between 20 and 32 weeks and weight between birth and two years (Δweight z-score) were computed. Conditional growth, adjusted for genetic growth potential and prior growth, was calculated for early pregnancy (conception to week 20), mid-to-late pregnancy (week 20 to birth), and infancy (birth to age two years). Outcome variables included dmft assessed at ages two, three and five years (ICDAS-II; WHO criteria) and high /low caries cluster (HCC/LCC) identified by K-means for longitudinal trajectories, with adjusted risk ratios (RRs) estimated by modified Poisson regression.

Results:

Higher early-pregnancy conditional growth reduced HCC risk (ICDAS RR [95% CI] = 0.87 [0.77–0.98]; WHO RR = 0.80 [0.68–0.95]). Extreme fetal growth deceleration (ΔFAC z-score ≤ –2) increased caries risk at two years (ICDAS RR = 2.83 [1.16–6.87]), extreme acceleration (ΔFAC z-score ≥ 2) at five years (ICDAS RR= 1.35 [1.1-1.65]; WHO RR = 1.98 [1.47–2.68]), and extreme postnatal growth deceleration (Δweight z-score ≤ –2) at three years (ICDAS RR = 1.96 [1.35-2.86]; WHO RR = 3.40 [1.60–7.20]).

Conclusions:
Marked deviations in fetal and infant growth heightened susceptibility to ECC. Conditional growth modelling uncovered a novel oral–systemic link, identifying early pregnancy as a critical window for mitigating ECC risk.



Identify Supporting Agency and Grant Number:
Research supported by Faculty of Dentistry, National University of Singapore, Grant number: A-0002938-00-00.