51: Periodontal disease and adverse birth outcomes: A study from Pakistan

Abstract

Periodontal disease may increase the risk of adverse birth outcomes; however, results have been mixed. Few studies examined periodontal disease in developing countries. We describe the relationship of periodontal disease to birth outcomes in a community setting in Pakistan. Enrollment occurred at 20-26 wks. A study dentist performed the periodontal examination to assess probing depth (PD), clinical attachment level (CAL), gingivitis index (GI) and plaque index (PI). Outcomes included stillbirth (SB), neonatal mortality (NM), <32 wk preterm birth (PTB), 32-36 wk PTB, and LBW, and are presented for increasing periodontal disease severity by quartiles (Q1-4). Dental examinations were completed for 1341women. 81% were multiparous with a mean age of 27 yr. 33% were illiterate. Dental caries were present in 47%, missing teeth in 27% and 92% had no dental care in the last year. Periodontal disease was common: 87% had ≥4 teeth with a PD of >3mm, 54% had ≥4 teeth with a PI of >3 and 58% had ≥4 teeth with a GI of >3. In general, as the measure of periodontal disease increased, SB, PTB<32 wks and NM worsened (Table). Late PTB and LBW were not related to measures of periodontal disease. Adjustment for demographic characteristics did not change the relationships.Tabled 1Pregnancy outcomes vs. periodontal diseaseSB/1000<32wk/1000NM/1000PD Q1191141Q2–3312987Q4412296p-value0.0550.1560.088CAL Q1261549Q2–3272582Q4422699p-value0.1090.2360.016PI Q1221362Q2–3262967Q44719113p-value0.0480.2810.013GI Q124848Q2–3253079Q44822102p-value0.0290.0830.006 Open table in a new tab High levels of moderate to severe dental disease are present in pregnant Pakistani women. SB, early PTB, and NM increase with the severity of periodontal disease.