Early-life factors affect risk of pain and fever in infants during teething periods.

Abstract

This longitudinal study aimed to investigate the prevalence of teething-related pain and fever and the early-life factors that may affect the risk of experiencing these disturbances within the first 1.5years of life. Participants were recruited (n=1033) through the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n=1237). Interviews were performed tri-monthly regarding the prevalence of teething pain and fever in children from 6 to 18months of age. Crude and multivariable analyses were conducted using Poisson-log regression models. Prevalence rates for teething pain and fever were 35.5 and 49.9% respectively. Multivariable Poisson regression analysis showed maternal second-hand tobacco smoke (SHS) exposure to increase the risk of both pain (mean ratio=1.35; p=0.006) and fever (mean ratio=1.22; p=0.025), whereas SHS exposure plus active smoking further increased risk of teething pain in the children (mean ratio=1.89; p=0.029). Delivery via Caesarean section increased risk of teething pain (mean ratio=1.27; p=0.033), while prenatal plasma vitamin D insufficiency lowered such a risk (mean ratio=0.62; p=0.012). Compared to Chinese infants, Indian babies exhibited lower risk of teething pain and fever (both p≤0.001). Early-life factors such as tobacco smoke exposure and vitamin insufficiency during pregnancy, ethnicity and childbirth via Caesarean section may significantly affect the child's susceptibility to teething-related pain and fever. Knowledge of prevalence and risk factors of teething disturbances may better equip primary caregivers and healthcare professionals to accurately detect teething-related local and/or systemic signs/symptoms and effectively facilitate tobacco cessation among pregnant women.