Doença periodontal e resultados perinatais adversos em uma coorte de gestantes / Periodontal disease and adverse perinatal outcomes in a pregnant women cohort

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

This study was aimed to evaluate the prevalence of periodontal disease in a sample population of low-risk pregnant women, the factors associated with it and its correlation with the occurrence of adverse perinatal outcomes, including preterm births, low birth weigth, small for gestational age babies and premature rupture of the membranes. This cohort study included 334 pregnant women under prenatal care at the Hospital das Clinicas of the University of Campinas, Brazil, who voluntarily accepted to participate and had one single periodontal examination performed in the same day of a prenatal visit. Data was collected from anamnesis, periodontal clinical exam, and from information regarding pregnancy, delivery and postpartum. The clinical periodontal parameters were: plaque index, bleeding on probing index, probing pocket depth, clinical attachment level and gingival recession. Pregnant women were divided into two groups: those with moderate-to-severe periodontitis (P2-P4) and those with no disease or only mild disease (P0-P1), according to the WS classification index. Age, parity, race/color, years of schooling, marital status, number of prenatal visits, dietary habits, BMI (body mass index), smoking habits, use of alcohol and drugs, use of medication and presence of systemic diseases d bacterial vaginosis were also evaluated. Initially a cross sectional analytic approach was used for identifying factors associated with the occurrence of periodontal disease during pregnancy. After that, a real cohort approach was used, with the estimate of the risk of adverse perinatal outcomes (preterm birth, low birth weight, small for gestational age baby and premature rupture of membranes, the main dependent variables of this study) according to the condition of periodontal disease. Distribution of independent variables within the two groups was analyzed by calculating prevalence ratios and their respective 95% confidence intervals for the cross sectional approach. Uni and multivariate analysis for the estimation of the risk of adverse perinatal outcomes were performed for the cohort approach. The Risk Ratior and its 95%CI were estimated for each outcome. The significance level assumed was 5%. The prevalence of moderate to severe periodontitis in 334 pregnant women was 47%, and it was significantly associated with more advanced gestational age at periodontal examination (17-24 weeks: PR 1.40, 95%CI 1.01-1.94; and 25-32 weeks: PR 1.52, 95%CI 1.10 ? 2.08), with maternal age between 25 - 29 years (PR 1.65, 95%CI 1.02 ? 2.68), with obesity (PR 1.38, 95%CI 1.04 ? 1.82) and with the presence of gingival bleeding (ORadjusted 2.01, 95%CI 1.41 ? 2.88). The data of 327 deliveries were collected and, among them, the periodontal disease was associated to a higher risk of preterm birth (RR 3.47 95%CI 1.62-7.43), of low birth weight (RR 2.93 95%CI 1.36-6.34) and of premature rupture of membranes (RR 2.48 95%CI 1.35-4.56) in the multivariate analysis. The prevalence of periodontal disease among low-risk pregnant women is high and it is associated with more advanced gestational age, obesity and gingival bleeding. Periodontal disease was a risk factor for the occurrence of preterm birth, low birth weight and premature rupture of membranes

ASSUNTO(S)

fetal membranes doença periodontal oral health risk factors periodontal diseases gravidez fatores de risco ruptura prematura de membranas fetais premature rupture infant premature saude bucal prematuros pregnancy

Documentos Relacionados