Periodontal disease during pregnancy: assessment of determinants of health and quality of life in pregnant women with periodontitis
Keywords:Periodontitis; Pregnancy; Quality of Life; Socioeconomic analysis.
Periodontitis in pregnancy may be associated with several determinants of health and knowing these determinants makes possible an integral approach of the patients. The aim of this study was to evaluate the determinants of health and periodontitis-related quality of life in pregnant women. Sample was composed by 128 patients divided into two groups: pregnant women with periodontitis (GP = 64) and without periodontitis (GWP = 64) during the third trimester of pregnancy. They were evaluated regarding: a) socioeconomic level; b) anthropometric parameters; c) systemic conditions - presence of arterial hypertension and diabetes mellitus; d) behaviors regarding oral hygiene; and e) oral health impact profile (OHIP-14). T-test, Mann-Whitney U-test, chi-square and logistic regression were applied, considering a significance level of 5%. GP showed low socioeconomic level (P = 0.0008), high maternal body mass index (BMI) (P = 0.0002) and excessive gestational weight gain (P = 0.008). No intergroup differences were observed in systemic conditions. Patients with periodontitis presented low daily dental floss use (P = 0.021) and strong impact on quality of life for all evaluated dimensions (P < 0.05). Periodontitis in pregnancy was associated with high BMI, excessive gestational weight gain, low socioeconomic level, poor oral hygiene behaviors and negative impact on quality of life.
Acharya, S., & Bhat, P. V. (2009). Oral-health-related quality of life during pregnancy. J Public Health Dent, 69(2), 74-77. https://doi.org/10.1111/j.1752-7325.2008.00104.x.
Acharya, S., Bhat, P. V., & Acharya, S. (2009). Factors affecting oral health-related quality of life among pregnant women. Int J Dent Hyg, 7(2), 102-107. https://doi.org/10.1111/j.1601-5037.2008.00351.x.
Bastos, R. S., Carvalho, E. S., Xavier, A., Caldana, M. L., Bastos, J. R. M., & Lauris, J. R. P. (2012). Dental caries related to quality of life in two Brazilian adolescent groups: a cross-sectional randomised study. Int Dent J, 62(3), 137-143. https://doi.org/10.1111/j.1875-595X.2011.00105.x.
Caracho, R. A., Foratori-Junior, G. A., Fusco, N. D. S., Jesuino, B. G., Missio, A. L. T., & Sales-Peres, S. H. C. (2020). Systemic conditions and oral health-related quality of life of pregnant women of normal weight and who are overweight. Int Dent J, 70(4), 287-295. https://doi.org/10.1111/idj.12547.
Chapper, A., Munch, A., Schermann, C., Piacentini, C. C., & Fasolo M. T. M. (2005). Obesity and periodontal disease in diabetic pregnant women. Braz Oral Res, 19(2), 83-87. https://doi.org/10.1590/s1806-83242005000200002.
Foratori-Junior, G. A., da Silva, B. M., da Silva Pinto, A. C., Honório, H. M., Groppo, F. C., & Sales-Peres, S. H. C. (2020a). Systemic and periodontal conditions of overweight/obese patients during pregnancy and after delivery: a prospective cohort. Clin Oral Investig, 24(1), 157-165. https://doi.org/10.1007/s00784-019-02932-x.
Foratori-Junior, G. A., Jesuino, B. G., Caracho, R. A., Orenha, E. S., Groppo, F. C., & Sales-Peres, S. H. C. (2020b). Association between excessive maternal weight, periodontitis during the third trimester of pregnancy, and infants' health at birth. J Appl Oral Sci, 28, e20190351. https://doi.org/10.1590/1678-7757-2019-0351.
Foratori-Junior, G. A., Missio, A. L. T., Orenha, E. S., & Sales-Peres, S. H. C. (2021). Systemic Condition, Periodontal Status, and Quality of Life in Obese Women During Pregnancy and After Delivery. Int Dent J. https://doi.org/10.1016/j.identj.2020.12.012.
Fusco, N. D. S., Foratori-Junior, G. A., Missio, A.L.T., Jesuino, B. G., & Sales-Peres, S. H. C. (2019). Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system. Int Dent J, 69(6), 472-479. https://doi.org/10.1111/idj.12507.
Gao, X., Yan, Y., Xiang, S., Zeng, G., Liu, S., Sha, T., He, Q., Li, H., Tan, S., Chen, C., Li, L., & Yan, Q. (2017). The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One, 12(6), e0177418. https://doi.org/10.1371/journal.pone.0177418.
Garcia, É. M., Martinelli, K. G., Gama, S. G. N. D., Oliveira, A. E., Esposti, C. D. D., & Santos Neto, E. T. D. (2019). Gestational risk and social inequalities: a possible relationship?. Cien Saude Colet 24(12), 4633-4642. https://doi.org/10.1590/1413-812320182412.31422017.
Geevarghese, A., Baskaradoss, J. K., & Sarma, P. S. (2017). Oral Health-Related Quality of Life and Periodontal Status of Pregnant Women. Matern Child Health J, 21(8), 1634-1642. https://doi.org/10.1007/s10995-016-2255-y.
González-Jaranay, M., Téllez, L., Roa-López, A., Gómez-Moreno, G., & Moreu, G. (2017). Periodontal status during pregnancy and postpartum. PLoS One, 12(5), e0178234. https://doi.org/10.1371/journal.pone.0178234.
Gunderson, E. P., Hurston, S. R., Dewey, K. G., Faith, M. S., Charvat-Aguilar, N., Khoury, V. C., Nguyen, V. T., & Quesenberry, C. P. Jr. (2015). The study of women, infant feeding and type 2 diabetes after GDM pregnancy and growth of their offspring (SWIFT Offspring study): prospective design, methodology and baseline characteristics. BMC Pregnancy Childbirth, 15, 150. https://doi.org/10.1186/s12884-015-0587-z.
Hosmer, D.W., & Lemeshow, S. (2000). Applied logistic regression. 2nd Edition, John Wiley & Sons, Inc., New York. https://doi.org/10.1002/0471722146.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines., Rasmussen, K. M., & Yaktine, A. L. (2009). Weight Gain During Pregnancy: Reexamining the Guidelines.
International Association of Diabetes and Pregnancy Study Groups Consensus Panel., Metzger, B. E., Gabbe, S. G., Persson, B., Buchanan, T. A., Catalano, P. A., Damm, P., Dyer, A. R., Leiva, A. d., Hod, M., Kitzmiler, J. L., Lowe, L. P., McIntyre, H. D., Oats, J. J. N., Omori, Y., & Schmidt, M. I. (2010). International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care, 33(3), 676-682. https://doi.org/10.2337/dc09-1848.
Jesuino, B. G., Foratori-Junior, G. A., Missio, A. L. T., Mascoli, L. S., & Sales-Peres, S. H. C. (2020). Periodontal status of women with excessive gestational weight gain and the association with their newborns' health. Int Dent J, 70(5), 396-404. https://doi.org/10.1111/idj.12580.
Lee, H. J., Jun, J. K., Lee, S. M., Ha, J. E., Paik, D. I., & Bae, K. H. (2014). Association between obesity and periodontitis in pregnant females. J Periodontol, 85(7), e224-e231. https://doi.org/10.1902/jop.2014.130578.
Lenfant, C., & National Education Program Working Group on High Blood Pressure in Pregnancy. (2001). Working group report on high blood pressure in pregnancy. J Clin Hypertens (Greenwich), 3(2), 75-88.
Lu, H. X., Xu, W., Wong, M. C. M., Wei, T. Y., & Feng, X. P. (2015). Impact of periodontal conditions on the quality of life of pregnant women: a cross-sectional study. Health Qual Life Outcomes, 13, 67. https://doi.org/10.1186/s12955-015-0267-8.
Nishimura, F., Iwamoto, Y., Mineshiba, J., Shimizu, A., Soga, Y., & Murayama, Y. (2003). Periodontal disease and diabetes mellitus: the role of tumor necrosis factor-alpha in a 2-way relationship. J Periodontol, 74(1), 97-102. https://doi.org/10.1902/jop.2003.74.1.97.
Oliveira, B. H., & Nadanovsky, P. (2005). Psychometric properties of the Brazilian version of the Oral Health Impact Profile-short form. Community Dent Oral Epidemiol, 33(4), 307-314. https://doi.org/10.1111/j.1600-0528.2005.00225.x.
Piscoya, M. D., Ximenes, R. A., Silva, G. M., Jamelli, S. R., & Coutinho, S. B. (2012). Periodontitis-associated risk factors in pregnant women. Clinics (Sao Paulo), 67(1), 27-33. https://doi.org/10.6061/clinics/2012(01)05.
Silk, H., Douglass, A. B., Douglass, J. M., & Silk, L. (2008). Oral health during pregnancy. Am Fam Physician, 77(8), 1139-1144.
Silva de Araujo Figueiredo, C., Gonçalves Carvalho Rosalem, C., Costa Cantanhede, A. L., Abreu Fonseca Thomaz É. B., & Fontoura Nogueira da Cruz, M. C. (2017). Systemic alterations and their oral manifestations in pregnant women. J Obstet Gynaecol Res, 43(1), 16-22. https://doi.org/10.1111/jog.13150.
Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol, 20, S149-S161. https://doi.org/10.1111/jcpe.12945.
Turton, M.; & Africa, C. W. J. (2017) Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes. Int Dent J, 67(3), 148-156. https://doi.org/10.1111/idj.12274.
Udagawa, S., Katagiri, S., Maekawa, S., Takeuchi, Y., Komazaki, R., Ohtsu, A., Sasaki, N., Shiba, T., Watanabe, K., Ishihara, K., Sato, N., Miyasaka, N., & Izumi, Y. (2018). Effect of Porphyromonas gingivalis infection in the placenta and umbilical cord in pregnant mice with low birth weight. Acta Odontol Scand, 76(6), 433-441. https://doi.org/10.1080/00016357.2018.1426876.
Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., Egger, M., & STROBE Initiative. (2014). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Int J Surg, 12(12), 1500-1524. https://doi.org/10.1016/j.ijsu.2014.07.014.
Vogt, M., Sallum, A. W., Cecatti, J. G., & Morais, S. S. (2012). Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reprod Health, 9, 3. https://doi.org/10.1186/1742-4755-9-3.
Zimmermann, G. S., Bastos, M. F., Dias Gonçalves, T. E., Chambrone, L., & Duarte, P. M. (2013). Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis. J Periodontol, 84(5), 624-633. https://doi.org/10.1902/jop.2012.120254.
How to Cite
Copyright (c) 2021 Alana Luiza Trenhago Missio; Gerson Aparecido Foratori-Junior; Bruno Gualtieri Jesuino; Leonardo da Silva Máscoli; Nathália dos Santos Fusco; Rafaela Aparecida Caracho; Carla Andreotti Damante; Silvia Helena de Carvalho Sales-Peres
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.