Relationship between preterm birth and developmental defects of enamel: A systematic review and meta-analysis

Background: A putative relationship between preterm birth and developmental defects of enamel (DDE) has been described in the literature. Although systematic reviews have found preterm birth may lead to DDE, the effect size has not been quantified. Aim: The aim of this systematic review and meta-analysis is to determine the association between preterm birth and DDE. Design: An electronic search was performed in Pubmed, Cochrane Library, Scopus and Web of Science to identify relevant studies. Two independent reviewers selected the studies in a two-stage process in accordance with the PRISMA statement. The risk of bias was also analysed using the Newcastle-Ottawa Scale criteria. Results: A total of 1041 publications were considered after an electronic search, 20 of which were included in the systematic review. Of these 20 publications,18 articles were included in a meta-analysis. The meta-analysis detected an increased risk of developing DDE in preterm children [OR: 3.27 (95% CI 2.02, 5.30; p<0.001)], with a greater risk in the primary dentition. In addition to this, a subgroup analysis showed a greater risk in the development of hypoplasia in preterm children. Conclusions: The results of this meta-analysis showed a three times increased risk of developing DDE in preterm children.