Maternal Factors and Birth Delivery Impact on Severe Early Childhood Caries

Objectives: To assess differences in Severe Early Childhood Caries (SECC) rates based on maternal illness during pregnancy, pregnancy term (preterm vs. full term), and delivery method (cesarean section vs. vaginal delivery). The study aims to identify potential birth-related risk factors contributing to SECC in pediatric patients. Methods. The study was approved by the Institutional Review Board and conducted at the University of Illinois Chicago (UIC) pediatric dentistry department. This retrospective cohort study reviewed patient charts from the Infant Oral Health (IOH) Clinic at UIC’s pediatric dentistry department. Patient data collected from the axiUm® electronic health records system between August 1, 2021, and August 31, 2023, included children aged 0 to 3 years, with oral health outcomes assessed using dmfs (decayed, missing, and filled surfaces) scores and dmft (decayed, missing, and filled teeth) scores. A total of 521 out of 801 eligible mother-child pairs met the predefined inclusion criteria. The data were analyzed using descriptive statistics, the Kruskal-Wallis test, Fisher’s Exact Test, and regression analysis to evaluate potential associations between birth-related factors and dmfs SECC rate. Results: The mean age of children in the study was 21.4 months, with a median dmft score of 5 and a median dmfs score of 0.1. Based on dmfs score categories, 28.8% of children fell into the low category (0.0 - 0.01), 12.1% in the medium category (0.01 - 0.06), and 59.1% in the high category (>0.06). Regarding maternal health during pregnancy, 79.5% of the mothers were healthy during pregnancy, while 20.5% ill. For birth term, 86.8% were full term, with 13.2% preterm. For delivery method, 74.4% were vaginal delivery, while 25.6% were cesarean sections. Statistical analysis showed that maternal health status during pregnancy was significantly associated with SECC, (p=0.031 for dmft score and p=0.042 for dmfs score). Neither pregnancy term (p= 0.666 for dmft score and p=0.650 for dmfs score) nor mode of delivery (p=0.091 for dmft score and p=0.076 for dmfs score) were significantly associated with the rates of Severe Early Childhood Caries (SECC). Conclusion: The results of this study indicate that maternal health factors during pregnancy play a more significant role in the development of Severe Early Childhood Caries (SECC) compared to birth-related factors such as pregnancy term or delivery method.