Peer-reviewed article

The association of perinatal factors with molar hypomineralization and caries - Results from an observational study.

Kühnisch J, Ammar N, Fresen KF, Gaballah R, Pernegger E et al. · 14 Sept 2026

Abstract

Objective Molar hypomineralization (MH) and caries are prevalent hard tissue defects. With respect to the unclear MH-etiology this observational study aimed to comprehensively investigate perinatal factors associated with both MH and caries. Methods A sample of 5418 school-aged children from Bavaria, Germany, was clinically examined, and their parents were asked to complete a questionnaire covering perinatal factors, using medical records (Maternal Health Record and Child Health Examination Booklet). A total of 1315 questionnaire were available for analysis using marginalized zero-inflated negative binomial regression. Incidence rate ratios (IRRs) and adjusted odds ratios (aORs) were calculated. Results Among all individuals, 20.0% (N = 263) were diagnosed with MH, and 39.9% (N = 525) were diagnosed with caries. Advanced parental age emerged as a significant risk factor for MH (aOR: 1.24 (1.02-1.50)), as did the use of general (IRR: 1.95 (1.16-3.27)) or regional anesthesia (aOR: 1.41 (1.16-1.71)). An increased risk of MH was also observed in children born via secondary Cesarean section (aOR: 1.43 (1.09-1.87)) or operative vaginal delivery (IRR: 1.37 (1.02-1.84)). Conversely, oxytocin administration for labour induction was associated with a lower rate of MH (aOR: 0.80 (0.66-0.96)). With respect to caries, the investigated variables showed weak, inconsistent, or no significant associations. Conclusion The results support the assumption that perinatal factors - particularly operative vaginal delivery, secondary Cesarean section, and associated anaesthetic procedures - are positively associated with MH. Future studies are warranted to confirm the reported associations. Clinical significance Etiology of MH remain unclear but perinatal factors may have a potential influence.