Impact of low birthweight on early childhood caries in 6–36 months old infants in Uganda: A cross-sectional study

Abstract

Objective. Focusing on 6–36 months old infants, this study assessed (1) whether socio-economic status, current anthropometric status, presence of enamel hypoplasia, number of erupted teeth, oral hygiene and consumption of sugared snacks varied between children with normal birthweight (NBW) and low birthweight (LBW) and (2) the association between ECC and birthweight whilst adjusting for covariates of ECC, such as current anthropometric status. Method: A cross-sectional study was conducted in Kampala in 2007, involving 816 child/caretaker pairs. All caretakers completed face-to-face interviews. Children were examined for ECC and enamel defects using WHO (1997) criteria and the developmental defects of enamel (DDE) index. Weight at birth was obtained from hospital records and current anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Results. Prevalence of LBW (< 2500 g) and ECC were estimated to 11.5% and 18.1%, respectively. Children with LBW and those with ECC presented with more visible plaque, higher sugar consumption and more current underweight (WAZ < −2) than children with normal birth weight (NBW) and no caries; 26.7% of LBW vs 17.3% (p < 0.001) of NBW children presented with ECC. Enamel defects (OR = 2.8, 95% CI = 1.6–4.8) and presence of visible plaque (OR = 2.4, 95% CI = 1.3–4.1), but not LBW, were associated with ECC in multiple variable logistic regression analyses. Conclusion. Both LBW and ECC were associated with poor oral hygiene, high intake of sugars and current underweight. Enamel defects were associated with ECC. Adjusting for covariates there were no clear association between LBW and ECC. Studies using a prospective study design are needed for further investigation.

Key Words::

• early childhood caries
• birthweigh
• sub-Saharan Africa

Acknowledgment

We would like to thank Dr Josephine Kayondo (JK) who was responsible for the data collection in Kampala and Ingunn Engebretsen for sharing a questionnaire developed locally among caretakers of infants and toddlers in Uganda. Dr Engebretsen has also been of great help when it came to calculating and interpreting the anthropometry measures. Thanks to the participants for making this study a reality.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.