Effect of birth weight and nutritional status on transverse maxillary growth: Implications for maternal and infant
Laura Jackeline Garcia Rincon1, Gizelton Pereira Alencar2, Marly Augusto Cardoso3
1Department of Politics, Management and Health, School of Public Health, University of São Paulo, São Paulo, Brazil.
Insights
Birth weight, sex, and nutritional status significantly impact children's transverse maxillary growth. Early interventions supporting adequate birth weight and nutrition are crucial for healthy jaw development and preventing malocclusion.
Area of Science:
- Pediatric Dentistry
- Public Health
- Human Growth and Development
Background:
- Transverse maxillary growth is crucial for dental arch development and overall facial structure.
- Factors such as birth weight and nutritional status may influence craniofacial development.
- Understanding these associations can inform early public health interventions.
Purpose of the Study:
- To analyze the association between birth weight, nutritional status, and transverse maxillary growth in schoolchildren.
- To investigate the influence of sex, birth weight, bottle-feeding patterns, and Body Mass Index-for-age z-score (BAZ) on maxillary growth.
Main Methods:
- Cross-sectional survey of 158 schoolchildren aged 7-9 years in the Western Brazilian Amazon.
- Transverse maxillary growth measured by upper intermolar distance (mm).
- Structural Equation Modeling (SEM) with path analysis used to assess direct, indirect, and total effects of exposures.
Main Results:
- Significant direct positive effects on transverse maxillary growth were found for sex (SC = 0.203), birth weight (SC = 0.155), and BAZ (SC = 0.165).
- Sex demonstrated significant indirect (SC = 0.057) and total (SC = 0.261) effects.
- Birth weight showed a significant total effect (SC = 0.174) on transverse maxillary growth.
Conclusions:
- Sex, birth weight, age of bottle introduction, and BAZ are associated with transverse maxillary bone growth.
- Policies promoting adequate birth weight, prenatal care, and full-term birth can positively influence maxillary development.
- Children with low birth weight, inadequate breastfeeding, or nutritional deficits may be at higher risk for jaw atrophy and malocclusion.
Abstract:
We analyzed the association between birthweight, nutritional status and transverse maxillary growth in 7- to 9-year-old schoolchildren. We undertook a cross-sectional survey nested in a population-based cohort study of 158 schoolchildren. The participants lived in the urban area of a small town within the Western Brazilian Amazon. The outcome was represented by the upper intermolar distance given in millimeters (mm), as an indicator of the degree of maxillary bone growth in its transverse dimension. The exposures were sex, birthweight, the bottle-feeding pattern operationalized by a scale corresponding to the age of introduction of the bottle and Body Mass Index-for-age z-score (BAZ) at 4 to 6 ys. Path analysis was employed to estimate standardized direct, indirect and total effects of exposures on the outcome using structural equations model (SEM) supported by Mplus 7 program. The values of standardized coefficients (SC) showed significant direct positive effects of sex (SC = 0.203; p = 0.006), birth weight (SC = 0.155; p = 0.030) and BAZ (SC = 0.165; p = 0.014) on transverse maxillary growth. The indirect effects (SC = 0.057; p = 0.012) and the total effect (SC = 0.261; p<0.001) of sex on the outcome were statistically significant. The indirect effects of birth weight on the outcome were not significant (SC = 0.018; p = 0.488), however, the total effect was significant (SC = 0.174; p = 0.011). In conclusion, sex, birthweight, bottle beginning age and BAZ showed association with the transverse growth of the maxillary bone. In addition to contributing to an adequate birth weight of the child, policies and programs that favor prenatal care and conditions to guarantee a full-term birth can positively affect transverse growth of the maxilla. From a Public Health Surveillance point of view, children with reduced birthweight, inadequate breastfeeding pattern and nutritional deficit for age may be more likely to develop atrophy of the jaws which, depending on the severity, may result in malocclusion with an important impact on quality of life.
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