Efeito da prematuridade na ocorrência de cárie aos quatro anos de idade: análise de associação e mediação em uma coorte brasileira de nascidos vivos

Abstract

Early childhood caries may be associated with preterm birth, as it affects dental development beginning during the intrauterine period. This study evaluated whether there was an association between prematurity and dental caries at four years of age and investigated whether variables related to dental development, dental eruption, and infant oral care mediate this relationship. This longitudinal study used data from the 2015 Pelotas (Brazil) Birth Cohort Study. The outcome was dental caries at four years, collected using ICDAS, and gestational age was defined by the date of birth and selfreported last menstrual period. Mediating variables included DDE, number of teeth at 12 months, oral hygiene practices, sugar consumption, and maternal guidance on children’s oral health. Analyses were performed using STATA 18.0. For bivariate associations, the chi-square test was used, and for numerical variables, the KruskalWallis and Mann-Whitney tests were applied. Poisson regression was used to evaluate associations, and structural equation modeling was used for mediation analysis. Children born at less than 34 weeks had a 40% lower incidence of caries at four years compared to those born after 39 weeks, and those born between 37 and 38 weeks had a 20% lower incidence. The number of teeth mediated this relationship, showing that lower gestational age resulted in fewer teeth at 12 months and lower caries occurrence. These findings highlight the importance of early dental monitoring and suggest preventive programs starting with the eruption of the first tooth, given its relevance in caries occurrence.