Journal of Prevention and Treatment for Stomatological Diseases ›› 2020, Vol. 28 ›› Issue (5): 307-312.doi: 10.12016/j.issn.2096-1456.2020.05.007

• Prevention and Treatment Practice • Previous Articles     Next Articles

Investigation on the influence of periodontal disease in gestation on small for gestational age

TANG Jing,YE Changchang(),XIA Zhongyi,WU Wanhong,HUANG Ping,WU Yafei()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontology West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-11-10 Revised:2020-01-23 Online:2020-05-20 Published:2020-04-24
  • Contact: Changchang YE E-mail:yechang111@163.com;yfw1110@163.com

Abstract:

Objective The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery.Methods A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups.Results The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05).Conclusion Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.

Key words: periodontal diseases, small for gestational age, socioeconomic factors, pregnancy, oral hygiene, premature delivery, low birth weight infants, periodontal treatment, probing depth

CLC Number: 

  • R781.4

Table 1

10th percentile for average birth weight of Chinese different gestational ages newborns during 2006-2010g"

Gender Gestational age(weeks)
28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Male 895 1 056 1 220 1 388 1 563 1 746 1 939 2 143 2 356 2 565 2 739 2 849 2 908 2 943 2 963 2 976
Female 830 992 1 157 1 325 1 499 1 680 1 871 2 071 2 279 2 482 2 652 2 764 2 824 2 854 2 868 2 875

Table 2

Demographic characteristics of subjects in the different periodontal groups (%)"

Periodontitis group
n=32)
Gingivitis group
n=171)
Health group
n=12)
F/Z/χ2 P
Population characteristics and questionnaire results
Median age(years) 29(26.3,32) 29(26,32) 28(26,29.8) 0.013 0.987
Bachelor′s degree or above 26(81.3%) 135(78.9%) 10(83.3%) 0.200 0.905
Monthly household income above 10 000 yuan 13(40.6%) 111(64.9%) 9(75.0%) 7.669 0.022*
Primiparity 23(71.9%) 137(80.1%) 10(83.3%) 1.246 0.536
BMI 19.85(19.0,22.1) 20.83(19.3,22.2) 21.51(19.9,22.9) 0.760 0.469
Nondrinkers 29(90.6%) 154(90.1%) 12(100.0%) 2.425 0.297
Quiet cooperation in mental state 30(93.8%) 165(96.5%) 12(100.0%) 1.409 0.494
Family history of periodontal disease 5(15.6%) 16(9.4%) 2(16.7%) 1.448 0.485
Normal sleep 32(100.0%) 168(98.2%) 12(100.0%) 1.385 0.500
Frequency of dental visits ≥ 1/year 7(21.9%) 72(42.1%) 5(41.7%) 4.670 0.097
Brushing frequency ≥ 2 times/d 30(93.7%) 167(97.7%) 12(100.0%) 1.866 0.390
Brushing time (≥ 3 minutes/time) 10(31.3%) 55(32.2%) 4(33.3%) 0.019 0.990
Use of mouthwash 10(31.3%) 59(34.5%) 4(33.3%) 0.131 0.937
Use of flossing 5(15.6%) 23(13.5%) 5(41.7%)1) 6.873 0.043
Participation in oral health insurance 25(78.1%) 123(71.9%) 8(66.7%) 0.757 0.685
Awareness of periodontal disease during pregnancy 18(56.3%) 111(64.9%) 7(58.3%) 1.946 0.378
Proportion of patients receiving basic periodontal treatment 19(59.4%) 84(49.1%) 3(25.0%) 4.282 0.118
Results of delivery
Birth weight (x ± s,g) 3 294.94±431.78 3 237.22±431.75 3 257.50±323.68 0.004 0.996
Gestational age (w) 39.36(38.5,40) 39.28(38.9,40) 39.29(38.2,40.4) 0.251 0.778
SGA 1(3.1%) 21(12.3%) 1(8.3%) 3.091 0.213
Cesarean section 17(53.1%) 96(56.1%) 8(66.7%) 0.670 0.715
Periodontal index
BOP% 61.61(44.2,79.1) 44.05(30.4,61.1) 5.36(5.8,5.4) 61.400 < 0.001*
Mean PD(mm) 3.06(2.8,3.6) 2.45(2.2,2.7) 1.73(1.5,2.0) 98.123 < 0.001*
PD ≥5 mm% 30.34(6.7,51.6) 3.57(0.6,17.9) 0.00(0.0,0.0) 70.473 < 0.001*
PD ≥4 mm% 62.20(27.7,94.3) 19.80(7.1,42.9) 0.55(0.0,3.6) 76.180 < 0.001*
PD ≥3 mm% 94.35(79.0,100) 67.86(41.1,96.4) 25.30(8.9,43.8) 47.046 < 0.001*
Mean CAL(mm) 3.27(31,3.8) 0.00(0.0,0.0) 0.00(0.0,0.0) 212.162 < 0.001*
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