title: Maternal Allostatic Load, Caretaking Behaviors, and Child Dental Caries Experience: A Cross-Sectional Evaluation of Linked Mother-Child Data From the Third National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  We evaluated the associations between chronic maternal stress measured by allostatic load (AL), maternal caretaking behaviors, and child dental caries experience. We also assessed the role of socioeconomic status in these associations.
  
  
  METHODS
  We used data from the Third National Health and Nutrition Examination Survey (1988-1994). We included children aged 2 to 6 years who linked to a maternal record (n = 716 maternal-child pairs). The main exposure was maternal AL index (0, 1, or ≥ 2). The primary outcome of interest was child dental caries experience (none or any). We evaluated the association between maternal AL and (1) maternal caretaking behaviors, and (2) child caries status and the role of socioeconomic status in these relationships.
  
  
  RESULTS
  Children of mothers with an AL index of at least 2 were significantly more likely to have not been breastfed and to have dental caries than were children of mothers with a normal AL before adjusting for measures of socioeconomic status.
  
  
  CONCLUSIONS
  Maternal chronic stress, indicated by elevation in markers of AL, has an important role in child caretaking behaviors and in children's oral health.
authors.affiliation: Erin E. Masterson is with the Departments of Epidemiology and Oral Health Sciences, Schools of Public Health and Dentistry, University of Washington, Seattle. Wael Sabbah is with the Division of Population and Patient Health, Dental Institute, King's College London, London, UK.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Masterson
authors.affiliation: Erin E. Masterson is with the Departments of Epidemiology and Oral Health Sciences, Schools of Public Health and Dentistry, University of Washington, Seattle. Wael Sabbah is with the Division of Population and Patient Health, Dental Institute, King's College London, London, UK.
authors.forename: Wael
authors.initials: W
authors.lastname: Sabbah
mesh_terms: D000328:Adult; D015415:Biomarkers; D001786:Blood Glucose; D001942:Breast Feeding / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009749:Nutrition Surveys; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D002097:C-Reactive Protein