1. Controlled Direct Effect of Early-Life Socioeconomic Position on Periodontitis in a Birth Cohort.
- Author
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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, and Do, Loc Giang
- Subjects
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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 - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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