tress during pregnancy has been associated with a number of poor health implications for offspring, including low birthweight and increased risk of asthma and allergies. But for the first time, a new study suggests chronic stress in pregnancy may increase a child's risk for dental caries.
Researchers say chronic stress during pregnancy may increase a child's risk for dental caries.
Dr. Wael Sabbah, of the Dental Institute at King's College London in the UK, and colleagues publish their findings in the American Journal of Public Health.
Tooth decay is the leading chronic childhood illness in the US. According to National Institute of Dental and Craniofacial Research, 42% of children aged 2-11 in the US have had dental caries, or tooth decay, in their primary teeth, while 21% of children aged 6-11 have had dental caries in their adult teeth.
Poor oral hygiene and high consumption of sugary foods and drinks are common causes of dental caries in children, but Dr. Sabbah and colleagues suggest the levels of stress a mother experiences throughout pregnancy may also play a role.
The research team - including investigators from the University of Washington in Seattle - analyzed the data of 716 children and their mothers who were part of the 1988-94 National Health and Nutrition Examination Survey (NHANES).
Children included in the study were aged 2-6 years, while their mothers were aged 30 and older.
Biological markers of chronic stress - as assessed by markers of allostatic load (AL) - were analyzed during mothers' pregnancy. Specifically, the team assessed blood levels of high-density lipoprotein (HDL) cholesterol, triglycerides, glucose and C-reactive protein, as well as their blood pressure and waist circumference.
In addition to monitoring the incidence of dental caries among offspring, the researchers assessed mothers' socioeconomic status, the number of child dental visits, whether mothers breastfed their offspring and whether offspring ate breakfast daily, among other care-related behaviors.
Maternal stress 'should be considered a potential risk factor for dental caries'
Compared with mothers who had no AL markers, those who had two or more were significantly more likely to have offspring with dental caries.
What is more, they found incidence of dental caries among offspring was more common among those who were not breastfed, and lower incidence of breastfeeding was significantly more common among mothers with lower income.
Lower-income mothers were also less likely to have taken their children to the dentist during the previous 12 months and less likely to feed their child breakfast each day, compared with mothers with higher income.
While previous studies have linked low socioeconomic status with increased risk of dental caries among offspring, the researchers say their study is the first to identify stress as a driver of this association.
First study author Erin E. Masterson, of the Schools of Public Health and Dentistry at the University of Washington, says:
"This study uniquely highlights the importance of considering the influence of socioeconomic status and maternal stress on children's oral health through mothers' struggles to adopt healthy patterns that are major predictors of dental cavities, such as brushing her children's teeth regularly, maintaining healthy dietary habits and taking regular visits to the dentist for preventive care."
The team admits that their findings do not indicate maternal chronic stress causes dental caries in offspring. However, Dr. Sabbah says their findings do suggest that policies to improve children's dental health should include strategies to improve mothers' quality of life during pregnancy.
"Chronic maternal stress as a potential risk factor is something we need to consider, in addition to the wider implications of maternal wellbeing, social, and psychological environment on dental health," he adds.