Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study Elisa Miranda Costa 1 & Juliana A. P. Azevedo 2 & Rafiza F. M. Martins 3 & Cláudia M. C. Alves 4 & Cecília C. C. Ribeiro 5 & Erika B. A. F. Thomaz 6 Received: 18 September 2016 /Accepted: 10 November 2016 # Springer Science+Business Media New York 2016 Abstract The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad’ s criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular he- moglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted asso- ciations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjust- ment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95–0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98– 0.99), ferritin (IRR = 0.99, 95%CI 0.98–0.99), erythrocyte (IRR = 0.71, 95%CI 0.50–0.99), hemoglobin (IRR = 0.84, 95%CI 0.73–0.96), hematocrit (IRR = 0.93, 95%CI 0.88– 0.98), MCV (IRR = 0.91, 95%CI 0.86–0.96), and MCH (IRR = 0.83, 95%CI 0.74–0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron de- ficiency anemia during pregnancy is a risk factor for the inci- dence of dental caries in these women. Keywords Anemia . Micronutrient deficiency . Dental caries . Pregnant women . Epidemiologic studies Introduction Pregnancy is characterized by several systemic changes in the woman’s body [ 1], among them, hypercoagulable and dilutional anemia [2]. Almost 38% of pregnant women are affected by anemia worldwide, resulting in 32 million women [3]. Gestational iron deficiency anemia has been associated with increased risk of low birth weight and prematurity, which can interfere with child’ s cognitive and motor development and make the infant more prone to future iron deficiency [4]. * Elisa Miranda Costa elisamirandac@hotmail.com Juliana A. P. Azevedo juairesodonto@hotmail.com Rafiza F. M. Martins rafizafelix@yahoo.com.br Cláudia M. C. Alves cmcoelhoa@gmail.com Cecília C. C. Ribeiro cecilia_ribeiro@hotmail.com Erika B. A. F. Thomaz ebthomaz@globo.com 1 Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão, Brazil 2 Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil 3 Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil 4 Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil 5 Department of Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil 6 Department of Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil Biol Trace Elem Res DOI 10.1007/s12011-016-0898-6