{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:08:05Z","timestamp":1788264485251,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["306592 \/ 2018\u20105"],"award-info":[{"award-number":["306592 \/ 2018\u20105"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"publisher","award":["Finance code 001"],"award-info":[{"award-number":["Finance code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003758","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa e ao Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico do Maranh\u00e3o","doi-asserted-by":"publisher","award":["00035\/2008; and finance support for the manuscript publication"],"award-info":[{"award-number":["00035\/2008; and finance support for the manuscript publication"]}],"id":[{"id":"10.13039\/501100003758","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthod Craniofacial Res"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation paths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Sample Population<\/jats:title><jats:p>Children evaluated at birth (T1), between 12 and 24\u00a0months (T2), and between 24 and 36\u00a0months (T3) were included. Two hundred and seventeen children who participated in T1 and T2 were randomly selected to perform the occlusion examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This is a prospective cohort study (BRISA). The theoretical model was tested by structural equation modelling (SEM), estimating standardized coefficients (Coeff.) (\u03b1\u00a0=\u00a00.05). The primary exposure was APO\u2014a latent variable manifested from three health problems at birth: low birthweight (LBW), pre\u2010term birth (PTB) and intrauterine growth restriction (IUGR), evaluated in T1. The outcomes were four different occlusal traits assessed in T3: overjet, anterior and posterior crossbite, and crowding. Each outcome's direct and indirect effects were tested, mediated by growth, breathing, breastfeeding, and pacifier use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no direct association between APO and any of the outcomes: overjet (Coeff.\u00a0=\u00a0\u22120.163,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.241), anterior crossbite (Coeff.\u00a0=\u00a0\u22120.696,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.065), posterior crossbite (Coeff.\u00a0=\u00a0\u22120.087,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.589) and crowding (Coeff.\u00a0=\u00a00.400,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.423). The indirect (total and specifics) effects tested also showed no association (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a0.05). However, APO was associated with lower child growth in all models; breastfeeding was associated with higher child growth in all models, and pacifier use was associated with overjet (Coeff.\u00a0=\u00a00.184,<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and posterior crossbite (Coeff.\u00a0=\u00a00.373,<jats:italic>P<\/jats:italic>\u00a0=\u00a0.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>APO was not a risk factor for overjet, crossbite and crowding in an early stage of the primary dentition by direct and indirect pathways. However, growth has been lower in children with APO and higher in children breastfed. Also, the harmful effects of using a pacifier in dental occlusion are highlighted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ocr.12563","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T16:29:41Z","timestamp":1641313781000},"page":"509-519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adverse pregnancy outcomes and occlusal traits in the primary dentition: A prospective cohort (BRISA)"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4162-9932","authenticated-orcid":false,"given":"Antonio Carlos","family":"Silva J\u00fanior","sequence":"first","affiliation":[{"name":"Postgraduate Program in Dentistry Federal University of Maranhao S\u00e3o Lu\u00eds Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4705-4914","authenticated-orcid":false,"given":"Cl\u00e1udia Maria 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