title: Association of characteristics of delivery and medical conditions during the first month of life with developmental defects of enamel.
abstract: BACKGROUND
  Developmental defects of enamel (DDE) may be influenced by health problems and illness in children. The aim of the study was to identify the main characteristics of birth (delivery) and adverse medical conditions during the first month of life that may be related to DDE in permanent teeth.
  
  
  METHODS
  1000 schoolchildren between the ages of 9 and 11 years were selected for this cross-sectional study by multistage randomization from four educational zones in Shiraz in 2013. Intraoral examination was used to diagnose DDE according to World Health Organization screening guidelines and the Modified DDE Index. The data on seven birth factors as well as health and nutritional conditions during the first month of life were collected by a questionnaire completed by the parents, and were analyzed with the chi-squared test, Spearman's correlation and binary logistic regression.
  
  
  RESULTS
  469 (48.2%) out of 974 schoolchildren had at least one permanent tooth with DDE. The defects were significantly related with Apgar score at birth <7 (p = 0.003) and illness during the first month (p = 0.035). The frequency of DDE was significantly lower in the third child in families compared to the first and second child (p = 0.005). However, DDE showed no significant relationship with gestational age, delivery type, birth weight, gender or type of feeding during early infancy.
  
  
  CONCLUSIONS
  Three associated factors were identified (birth Apgar score, illness during the first month of life, birth order) for DDE in permanent teeth. No specific illness was found to be significantly associated with DDE.
authors.forename: Mahtab
authors.initials: M
authors.lastname: Memarpour
authors.affiliation: Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. golkaria@sums.ac.ir.
authors.forename: Ali
authors.initials: A
authors.lastname: Golkari
authors.forename: Reihaneh
authors.initials: R
authors.lastname: Ahmadian
mesh_terms: D001034:Apgar Score; D001722:Birth Order; D001724:Birth Weight; D002648:Child; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D003743:Dental Enamel / Q000002:abnormalities*; D005248:Feeding Methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007492:Iran / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors