Developmental Defects of Enamel and Associated Factors in 2-Year-Old Children: A Birth Cohort Study.

Objectives: To assess the maternal and child factors associated with developmental defects of the enamel (DDE) in a cohort of 2-year-old children.

Methods: This study analysed data from the MINA-Brazil birth cohort study. A total of 800 mother-child pairs were surveyed. Oral clinical examinations were conducted using the modified DDE Index. Associated factors in the pre-, peri- and post-natal periods were collected by standardised procedures. Crude and adjusted Poisson regression models with robust variance, following a hierarchical framework selection of covariates, were used to determine the relationships between maternal and child factors and DDE.

Results: The prevalence of DDE was 29.5% (95% CI 26.3%-32.7%), and children's mean age was 23.8 ± 1.3 months. Maternal age below 21 years at the time of delivery (PR 1.51, 95% CI 1.16-1.98), pregnant women as the head of the family (PR 1.36, 95% CI 1.03-1.80), multiparity (PR 1.41, 95% CI 1.09-1.82), large for gestational age newborns (PR 1.47, 95% CI 1.13-1.91), otitis media in the first few months of life (PR 2.43, 95% CI 1.43-4.13) and stunting at 1 year (PR 2.21, 95% CI 1.38-3.54) were all associated with DDE.

Conclusions: Several maternal sociodemographic and obstetric factors, as well as perinatal morbidity and nutritional factors, may be determinants of DDE in infants. This emphasises the importance of child development and sociodemographic factors for oral health. Future studies should consider both longitudinal and transdisciplinary approaches.