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- Title
Controlled Direct Effect of Early-Life Socioeconomic Position on Periodontitis in a Birth Cohort.
- Authors
Schuch, Helena Silveira; Nascimento, Gustavo G; Peres, Karen Glazer; Mittinty, Murthy N; Demarco, Flavio Fernando; Correa, Marcos Britto; Gigante, Denise Petrucci; Horta, Bernardo Lessa; Peres, Marco Aurelio; Do, Loc Giang
- Abstract
This study used data from the 1982 Pelotas Birth Cohort Study, Brazil, to estimate the controlled direct effect of early-life socioeconomic position (SEP) on periodontitis at age 31 years, controlling for adulthood income and education, smoking, and dental hygiene. Sex was included as a covariate. Early-life SEP was measured at participant birth based on income, health services payment mode, maternal education, height, and skin color (lower versus middle/higher SEP). Periodontitis was assessed through clinical examination at age 31 years (healthy, mild periodontitis, or moderate-to-severe disease). Adulthood behaviors (smoking, dental hygiene) were the mediators, and adulthood SEP (education and income) represented the exposure-induced mediator-outcome confounders. A regression-based approach was used to assess the controlled direct effect of early-life SEP on periodontitis. Multinomial regression models were used to estimate risk ratios and their 95% confidence intervals. The prevalences of mild and moderate-to-severe periodontitis were 23.0% and 14.3%, respectively (n = 539). Individuals from the lowest early-life SEP had a higher risk of moderate-to-severe periodontitis controlled for mediators and exposure-induced mediator-outcome confounders: risk ratio = 1.85 (95% confidence interval: 1.06, 3.24), E value 3.1. We found that early-life SEP was associated with the development of periodontitis in adulthood that was not mediated by adulthood SEP and behaviors.
- Subjects
BRAZIL; CONFIDENCE intervals; DENTAL hygiene; HEALTH behavior; HEALTH education; INCOME; LONGITUDINAL method; MEDICAL care costs; ORAL hygiene; PERIODONTITIS; REGRESSION analysis; SEX distribution; SMOKING; MULTIPLE regression analysis; SOCIOECONOMIC factors; CHILDREN
- Publication
American Journal of Epidemiology, 2019, Vol 188, Issue 6, p1101
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwz054