Birth Certificate Linkage To Growth & Health Measures Us

点击翻译按钮获取中文摘要

This project uses data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-84), linked to birth certificates for sample children ages 2-83 mo (coordinated by Dr. Overpeck through an interagency agreement with NCHS/CDC) to explore the health consequences of intrauterine growth. The most recent analyses have focused on the effects of perinatal factors on motor and social development (MSD) and early childhood caries (ECC). Analyses have been completed related to MSD and are nearly completed for ECC. We determined the independent effects of birth weight and gestational age on MSD, using an age-appropriate scale from 2-47 mo. Three percent of the infants and children were born preterm LBW and 2.2% term LBW. Adjusting for confounders, preterm LBW children still had lower MSD scores (-1.5 points, p<0.0001), as did term LBW children (-0.8 points, p< 0.03). LBW status and preterm delivery were associated independently with small, but measurable delays in MSD through early childhood. Even for children only moderately LBW or moderately preterm, perinatal factors should be considered in association with other known risk factors for developmental delays in determining the need for clinical follow-up and evaluation. In other analyses, we examined the factors associated with ECC, specifically mild/moderate ECC (1-7 teeth affected) and severe ECC (8+ teeth affected), in children ages 3-5 years (N=3273), who were selected for study because at these ages all deciduous teeth should be fully erupted, but few have been naturally shed. While there was little effect of birth weight on the prevalence of ECC, we found that the prevalence of severe ECC was significantly higher among those born very preterm (11.1%) and moderately preterm (7.3%), compared with those born at term (3.6%). Mexican-American children and those with low family income also had higher prevalence rates. Analyses of the total nutrient intake, including sugar, from 24-hour recalls showed no association with the risk of ECC. In models adjusting for age at exam (in months), race/ethnicity, prenatal smoking, poverty level, birth weight, and the number of deciduous teeth, we found that children born very preterm (AOR=11.56, 95% CI 1.11-120.1) and preterm (AOR=2.24, 95% CI 0.60-8.48) were at increased risk for severe ECC. This is consistent with understanding about the timing of development of the deciduous dentition, such that early birth and poor mineralization might make the developing tooth crowns more vulnerable to caries. Future analyses will incorporate geographical data on exposure to fluoridated sources of water as a confounding factor