Early Childhood Caries, Gestational Age and Birth Weight: a Meta-analysis

Objectives: The aim of the systematic review was to evaluate caries experience in preschool children born preterm and/or with low birth weight (LBW) compared to those born full-term and/or with normal birth weight (NBW).
Methods: A search was conducted up to November 2018 on 8 databases. We included observational studies that evaluated association between caries and gestational age and/or birth weight in primary teeth, with no restriction of date of publication and language. A pair of independent reviewers selected studies, extracted data and assessed risk of bias. Primary outcomes were presence of dental caries according to gestational age (born preterm/ full-term) and birth weight (born LBW/ NBW). We meta-analyzed prevalence data for both outcomes, we calculated effect estimate (ES) of proportion of caries and respective 95%CI in all groups. Statistical heterogeneity was evaluated by I², and the random effect model was used when heterogeneity was high. The estimated proportions between groups were compared by Z-test of interaction (p<0.05).
Results: Sixty studies were included (56 in the meta-analysis). Studies were published between 1996 and 2018; the majority were published after 2010 (68.3%) and in English language (96.7%). There were a total of 175.705 children with mean age of 41.08±17.65 months. Preterm children had higher caries experience (ES=0.39; 95%CI=0.30-0.48, I²=97.93%, p<0.001) compared to full-term children (ES=0.30; 95%CI=0.20-0.39, I²=99.85%, p<0.001). LBW children had higher experience of caries (ES=0.40; 95%CI=0.33-0.47, I²=97.43%, p<0.001) compared to NBW children (ES=0.33, 95%CI=0.26-0.41, I²=99.72%, p<0.001). However, no statistical significant differences were found between proportions of caries and gestational age (Z=1.34, p=0.161) neither between proportions of caries and birth weight (Z=1.33, p=0.163).
Conclusions: Preterm and LBW preschoolers have a similar dental caries experience to those born full-term or with NBW (PROSPERO #CRD42018118086).