Fatores gestacionais e perinatais e defeitos de desenvolvimento de esmalte no bebê

Abstract

Enamel development defects (DDE) constitute structural enamel anomalies, which occur during the process of amelogenesis in the prenatal, natal, and postnatal periods. There are still gaps regarding the etiology of DDE, but adverse conditions at birth (ACB) such as low birth weight (LBW), preterm birth (NPT) and / or intrauterine growth restriction (IUGR) have been identified as possible risk factors for this outcome. Alterations in calcium homeostasis, an important mineral for tooth formation, in the face of ACB can support this association. However, maternal immune imbalance, bacterial infections and morbidities such as hypertension during pregnancy have not yet been studied as potential predictors of the occurrence of DDE. One of the major maternal immune components responsible for embryogenesis - chemokine (RANTES) (Regulated on Activation, Normal T Cell Expressed and Secreted) - has not yet been investigated for its role in amelogenesis. Thus, this paper tested the hypothesis that perinatal factors would be associated with the occurrence of DDE in the baby. For this, two prospective cohort studies were performed on a sample of 327 pregnant women and their infants, with data extracted from the prenatal cohort - BRISA. In the first study, whose main objective was to analyze the role of chemokine RANTES in DDE, a structural equation analysis was performed, considering the direct effect of RANTES in pregnant women on the occurrence of DDE in the child; and the indirect effect, mediated by TPN. The effect of the latent socioeconomic situation on DDE in the child was also evaluated. The results did not indicate the effect of socioeconomic factors and TPN on the DDE in the child, but demonstrated that the serum levels of RANTES have a direct and negative effect on the occurrence of DDE (CFP = -0.160; P = 0.021), suggesting that the component maternal immune system is involved in the process of amelogenesis. In the second study, we investigated the association between maternal bacterial infections and the occurrence of DDE in the baby, through analysis of causal inference with propensity score, in a sample of this same cohort. No associations were identified between these events. It is concluded that the gestational period needs to be monitored regarding the health effects of the baby's teeth.