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Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort

OBJECTIVES: The aim was to gain knowledge regarding the risk of perinatal death related to exposure to dental amalgam fillings in the mother. DESIGN: Population-based observational cohort study. SETTING: The Norwegian Mother and Child Cohort Study, a Norwegian birth cohort of children born in 1999–2...

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Autores principales: Björkman, Lars, Lygre, Gunvor B., Haug, Kjell, Skjærven, Rolv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286137/
https://www.ncbi.nlm.nih.gov/pubmed/30532171
http://dx.doi.org/10.1371/journal.pone.0208803
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author Björkman, Lars
Lygre, Gunvor B.
Haug, Kjell
Skjærven, Rolv
author_facet Björkman, Lars
Lygre, Gunvor B.
Haug, Kjell
Skjærven, Rolv
author_sort Björkman, Lars
collection PubMed
description OBJECTIVES: The aim was to gain knowledge regarding the risk of perinatal death related to exposure to dental amalgam fillings in the mother. DESIGN: Population-based observational cohort study. SETTING: The Norwegian Mother and Child Cohort Study, a Norwegian birth cohort of children born in 1999–2008 conducted by the Norwegian Institute of Public Health. PARTICIPANTS: 72,038 pregnant women with data on the number of teeth filled with dental amalgam. MAIN OUTCOME MEASURES: Data on perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0–7 days after birth) were obtained from the Medical Birth Registry of Norway. RESULTS: The absolute risk of perinatal death ranged from 0.20% in women with no amalgam-filled teeth to 0.67% in women with 13 or more teeth filled with amalgam. Analyses including the number of teeth filled with amalgam as a continuous variable indicated an increased risk of perinatal death by increasing number of teeth filled with dental amalgam (crude OR 1.065, 95% CI 1.034 to 1.098, p<0.001). After adjustment for potential confounders (mothers' age, education, body mass index, parity, smoking during pregnancy, alcohol consumption during pregnancy) included as categorical variables, there was still an increased risk for perinatal death associated with increasing number of teeth filled with amalgam (OR(adj) 1.041, 95% CI 1.008 to 1.076, p = 0.015). By an increased exposure from 0 to 16 teeth filled with amalgam, the model predicted an almost doubled odds ratio (OR(adj) 1.915, 95% CI 1.12 to 3.28). In groups with 1 to 12 teeth filled with amalgam the adjusted odds ratios were slightly, but not significantly, increased. The group with the highest exposure (participants with 13 or more teeth filled with amalgam) had an adjusted OR of 2.34 (95% CI 1.27 to 4.32; p = 0.007). CONCLUSION: The current findings suggest that the risk of perinatal death could increase in a dose-dependent way based on the mother’s number of teeth filled with dental amalgam. However, we cannot exclude that the relatively modest odds ratios could be a result of residual confounding. Additional studies on the relationship between exposure to dental amalgam fillings during pregnancy and perinatal death are warranted.
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spelling pubmed-62861372018-12-28 Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort Björkman, Lars Lygre, Gunvor B. Haug, Kjell Skjærven, Rolv PLoS One Research Article OBJECTIVES: The aim was to gain knowledge regarding the risk of perinatal death related to exposure to dental amalgam fillings in the mother. DESIGN: Population-based observational cohort study. SETTING: The Norwegian Mother and Child Cohort Study, a Norwegian birth cohort of children born in 1999–2008 conducted by the Norwegian Institute of Public Health. PARTICIPANTS: 72,038 pregnant women with data on the number of teeth filled with dental amalgam. MAIN OUTCOME MEASURES: Data on perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0–7 days after birth) were obtained from the Medical Birth Registry of Norway. RESULTS: The absolute risk of perinatal death ranged from 0.20% in women with no amalgam-filled teeth to 0.67% in women with 13 or more teeth filled with amalgam. Analyses including the number of teeth filled with amalgam as a continuous variable indicated an increased risk of perinatal death by increasing number of teeth filled with dental amalgam (crude OR 1.065, 95% CI 1.034 to 1.098, p<0.001). After adjustment for potential confounders (mothers' age, education, body mass index, parity, smoking during pregnancy, alcohol consumption during pregnancy) included as categorical variables, there was still an increased risk for perinatal death associated with increasing number of teeth filled with amalgam (OR(adj) 1.041, 95% CI 1.008 to 1.076, p = 0.015). By an increased exposure from 0 to 16 teeth filled with amalgam, the model predicted an almost doubled odds ratio (OR(adj) 1.915, 95% CI 1.12 to 3.28). In groups with 1 to 12 teeth filled with amalgam the adjusted odds ratios were slightly, but not significantly, increased. The group with the highest exposure (participants with 13 or more teeth filled with amalgam) had an adjusted OR of 2.34 (95% CI 1.27 to 4.32; p = 0.007). CONCLUSION: The current findings suggest that the risk of perinatal death could increase in a dose-dependent way based on the mother’s number of teeth filled with dental amalgam. However, we cannot exclude that the relatively modest odds ratios could be a result of residual confounding. Additional studies on the relationship between exposure to dental amalgam fillings during pregnancy and perinatal death are warranted. Public Library of Science 2018-12-07 /pmc/articles/PMC6286137/ /pubmed/30532171 http://dx.doi.org/10.1371/journal.pone.0208803 Text en © 2018 Björkman et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Björkman, Lars
Lygre, Gunvor B.
Haug, Kjell
Skjærven, Rolv
Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title_full Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title_fullStr Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title_full_unstemmed Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title_short Perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based MoBa cohort
title_sort perinatal death and exposure to dental amalgam fillings during pregnancy in the population-based moba cohort
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286137/
https://www.ncbi.nlm.nih.gov/pubmed/30532171
http://dx.doi.org/10.1371/journal.pone.0208803
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