Abstract
Introduction Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. Results There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. Conclusion There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.
Highlights
Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence
The project is open to any West Virginia Right from the Start participant, pregnant woman who is a West Virginia resident and has a West Virginia Medicaid card, as well as women who are postpartum/interconceptional having increased risk of poor pregnancy outcomes
Of the 3,930 women who participated in the Helping Appalachian Parents and Infants (HAPI) project prenatal services program and 2,282 who had an initial oral evaluation with a dentist, 891 completed all oral health aspects of the project (39.0%)
Summary
Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). Mississippi, Louisiana, Alabama, the District of Columbia, and West Virginia have the highest percentages of births that are low birthweight births [2]. Poor birth outcomes were reported to be associated with inadequate maternal gestational weight gain [3], parity, higher diastolic blood pressure [4], racism [5], other than non-Hispanic white race/ethnicity in the United States [6, 7], maternal education [8], multiple birth, smoking, alcohol consumption, gestational nutrition, caloric expenditure, prenatal care, vitamins, diabetes, maternal age, and infections (among others) [9]
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