Periodontal Disease In Pregnant Women Research Articles

Prevalence of periodontal disease in pregnant patients: a systematic review

Introduction: The stage of pregnancy involves different physiological variations that globally alter hormones, making a person's body the appropriate place for infections such as periodontal disease to develop. The objective of this study was to establish the prevalence relationship between periodontal disease and pregnant patients. Methods: articles not older than 5 years were examined, taking studies between 2017 and 2021, extracted from the main Pubmed, Science Direct, SCOPUS, Proquest and EBSCO databases, as well as for the development of the systematic review, the guidelines were followed. of PRISM. Results: For this work, different perspectives of both exclusion and inclusion were applied, for which several filters were passed, leaving 7 articles selected (n=1178). The different data found were passed through a process of extraction and subsequent ordering, following the standards of the study, as an analysis methodology, as well as the results. Conclusion: As a result, it was obtained that the prevalence of periodontitis in pregnant women is high, since in all the studies included in this investigation, percentages between 50% and 70% of prevalence in pregnant women were evidenced, this being a risk factor. This is important for pregnancy complications, as the newborn may show low birth weight or the mother a premature delivery, in addition to the physiological factors of a pregnant woman compromising the immune system, leaving her more prone to suffering this type of dental pathology.

Periodontal diseases in pregnant women as a risk factor: a concise systematic review

This study highlighted that periodontal diseases in pregnant women can be one of the determinants of low birth weight. Studies were carried out to verify the existence of an association between maternal periodontal disease and low birth weight. Gestational period, where the occurrence of periodontal diseases (PD) is more likely, due to its hormonal and physiological changes. Therefore, pregnant women must be alert and take proper care, have prenatal care with their dentist, in addition to their oral care, they must be alert to the risks of low birth weight and premature births. Infections in regions of the genitourinary tract, such as PD, may be associated with the occurrence of low birth weight newborns through the same mechanisms as other maternal and preterm birth infections. The contraction of the uterus and cervical dilation, acting as a trigger for premature birth, can be caused by inflammatory stimuli, which can induce hyperirritability of the uterine smooth muscles. The infection and the resulting inflammatory process can cause damage to the placenta, thereby restricting fetal development. Throughout life, a woman goes through several phases of hormonal fluctuations that, in addition to interfering with the reproductive system, exert influence on other organs and systems, such as the periodontium, particularly in the presence of preexisting gingival inflammation induced by plaque. During pregnancy, a woman is exposed to several significant hormonal changes, as the placenta produces high amounts of estrogen and progesterone, which in turn affect the oral tissues. It was concluded that black women aged over 40 years old are more likely to have PD, having a higher risk of low development to the fetus.

Association between Maternal Periodontitis and Development of Systematic Diseases in Offspring.

Periodontal disease (PD) is one of the most common oral conditions affecting both youths and adults. There are some research works suggesting a high incidence of PD in pregnant women. As an inflammatory disease of bacterial origin, PD may result in the activation of the pathways affecting the course and the pregnancy outcome. The authors, based on the literature review, try to answer the PICO question: Does maternal periodontitis (exposure) influence the incidence of complications rates in pregnancy and the development of systemic diseases in childhood and adult offspring (outcome) in the humans of any race (population) compared to the offspring of mothers with healthy periodontium (comparison)? The authors try to describe the molecular pathways and mechanisms of these interdependencies. There is some evidence that maternal periodontitis may affect the pregnancy course and outcome, resulting in preeclampsia, preterm delivery, vulvovaginitis and low birth weight. It can be suggested that maternal periodontitis may affect offspring epigenome and result in some health consequences in their adult life.

Is overweight associated with periodontitis in pregnant women? Systematic review and meta-analysis.

This systematic review and meta-analysis aimed to generate pooled evidence for the association between excessive weight and pregnancy induced periodontitis. EMBASE, SCOPUS, PubMed/MEDLINE, Web of Science, BVS/LILACS, Cochrane Library and SCIELO databases were accessed. Eligibility criteria were: human clinical studies published between year 2000 and 2021. Newcastle-Ottawa scale was used to evaluate risk of bias of the studies. Meta-analysis was performed using MedCalc® Statistical Software. Eleven studies were included, evaluating 2152 pregnant women (743 with overweight/obesity and 1409 with normal body mass index - BMI), with a mean age of 29.62 years. Most studies had low risk of bias. A positive association between overweight/obesity and periodontitis was found, with an average of 61.04% of women with overweight/obesity and periodontitis, showing the overall random-effects relative risk and 95% CI of 2.21 (1.53–3.17) (p < 0.001). Arterial hypertension, gestational diabetes mellitus and excessive gestational weight gain were the most common adverse effects of maternal obesity that may have been linked to periodontitis induced pro-inflammatory state. In conclusion, a positive association was found between overweight/obesity and periodontitis during pregnancy. However, the high heterogeneity between the studies related to sample size, periodontal classification and the cutoff-points for BMI are the main limitation.

Питання профілактики та лікування захворювань пародонта у вагітни

Представлено аналіз літературних джерел щодо способів профілактики та методів лікування захворювань пародонта у вагітних. Обгрунтовано актуальність подальшого вивчення даного питання.

Periodontal Disease in Pregnant Women and Impact on in Tabuk Region, Saudi Arabia

Background: Periodontal disease is amongst the top ten most common diseases to affect humans and the leading cause of tooth loss for adults, so it’s important to be aware of the condition and how it can develop.Periodontitis is an inflammatory process initiated by bacterial plaque involving the supporting structures of the tooth which include the gingiva, the junctional epithelium, root cementum, periodontal ligament, and alveolar bone.&#x0D; Methods: A cross-sectional study using a self-managed questionnaire conducted among 127 pregnant women in King Salman Armed Forces Hospital in Tabuk region, Saudi Arabia (2020).&#x0D; Results: the study found that 69.3% of cases had symptoms of periodontitis. Also, the study found that there were no significant correlations betweensymptoms of periodontitis and all variables like; age group, marital status, educational level, employment, number of children, brushing daily, and visiting dental clinic during pregnancy (p&gt;0.05). As regards symptoms of periodontitisassociated with pregnancy, our study reported that 56.7% had Bleeding per gum, 44.9% had gum swelling and 40.9% had an offensive odor from the mouth.&#x0D; Conclusion: The study concluded that the majority of pregnant women cases had periodontitis and there was no significant association found with different variables like age, educational level, marital status. Also, there was good practice and attitude toward pregnancy-associated periodontitis.

Periodontology and pregnancy: An overview of biomedical and epidemiological evidence.

Women are particularly susceptible to developing gingival problems during pregnancy. In addition, periodontal disease in pregnant women may lead to adverse outcomes for both mother and infant, which have serious clinical and public health implications. Both scenarios have been extensively researched, helping to bring attention to pregnant women as an important and vulnerable population as it concerns periodontal health. The increase in gingival inflammation caused by hormonal changes in pregnant women is undisputed and has been studied and documented since the 1960s, although the exact etiology is not fully understood. The relationship between periodontal disease during pregnancy and adverse pregnancy outcomes is less substantiated, because of conflicting evidence. This review of the biomedical and epidemiologic literature provides an overview of both sides of this relationship and examines the potential mechanisms for developing periodontal disease during pregnancy and the proposed mechanisms by which periodontal disease leads to adverse pregnancy outcomes.

Стан тканин пародонту у вагітних різних вікових груп

There are numerous domestic and foreign studies of periodontal disease in pregnant women, but there are still a number of unresolved issues. The data about the development of periodontal tissue diseases in pregnant women in terms of age is not enough. The purpose of this work was to study the development of periodontal disease in pregnant women in different age groups. Material and methods. A survey of 83 women in the ІІ and ІІІ trimesters of pregnancy, aged 19-45 years, was divided into three groups according to age. Group I (34 people) included pregnant women aged 19-25 years, group II (29 people) had pregnant women aged 26-35 years, group III (20 people) comprised pregnant women aged 36-45 years. Periodontal and hygienic indices were determined to assess the clinical signs of periodontal disease (to assess the clinical signs of periodontal disease, periodontal and hygienic indices were determined (papillary-marginal-alveolar index, degree of bleeding gums, Schiller-Pisarev test, numerical value of Schiller-Pisarev test – Svrakov's number and simplified index of cavity hygiene). Results and discussion. The obtained results indicated a high level of periodontal disease in pregnant women. Periodontal disease was found in 74.7% of subjects. The study found a significant progression of periodontal tissue pathology in pregnant women over 26 years of age, indicating that women in this age group were at significant risk of periodontal disease. The obtained data indicated that the value of the bleeding index was the lowest in pregnant women with periodontal disease of group I, and the highest in women of group III. The value of the PMA index differed 1.3 times (p˂0.05) in pregnant women of groups I and II, 1.2 times (p˂0.05) in women of groups II and III, and 1.5 times (p˂0.05) in pregnant women of groups I and III. In addition, the likelihood of developing periodontal disease increased with age of women. Conclusion. The values of the Svrakov's number had a similar tendency to increase in age groups, as well as the results of the previously described indices. Hygiene in pregnant women of all ages who had periodontal disease was not very good. Thus, special attention should be paid to the timely diagnosis, treatment and prevention of periodontal disease in pregnant women, taking into account their age

Periodontal Diseases in Pregnant Women in Prenatal Consultation

Background: The relationship between pregnancy and periodontal health had well documented in the literature. Of many studies of periodontal diseases in the Democratic Republic of Congo, no study had evaluated these diseases in pregnant women during Prenatal Consultation (PC). This study aimed to describe the occurrence and clinical profile of periodontal diseases in pregnant women admitted to the PC at the General Military Hospital of BOBILA. Materials and Methods: It is a cross-sectional and analytical study of pregnant women admitted to the PC from August to December 31, 2018, at the General Reference Military Hospital of BOBILA/Kinshasa City. The data were collected through a survey combined with the stomatological interview. Sociodemographic data, clinical and periodontal indices included Oral Hygiene Index Simplified (OHI-S), Bleeding on Probing (BOP), and Periodontal Disease Index (PDI) were assessed. The statistical analyses were carried out using the SPSS version 20.0 software. The Chi-square tests, Student t-test were used to determine differences in the distribution of variables, and the odd Ratio with a confidence interval (IC) at 95% was used to estimate the degree of association. The results were significant at p < 0.05. Results: Of the 105 pregnant women received at the PC, 83 were included in this study. The age group between 20 - 29 was the most represented, with a predominance of stay-at-home mothers (75.9%) and married cases (73.4%), they had an average economic status (56.6%) and a secondary education level (63.8%). Gingival bleeding (44.6%) was the main complaint of the pregnant. Gestational age was a significant factor associated with gum bleeding (p < 0.005). Most of the pregnant had poor oral hygiene, localized gravidities (69.6%) during the third semester. Conclusion: A significant proportion of women had experienced periodontal diseases during the pregnancy period, mostly in the third trimester, and was associated with a gestational age of pregnant women.

EFFICIENCY OF TREATMENT OF INFLAMMATORY PERIODONTAL DISEASES IN PREGNANT WOMEN

The aim: To study the clinical efficciency of the proposed scheme of gingivitis treatment in women with physiological course of pregnancy. Materials and methods: Clinical approbation of the proposed complex of therapeutic and prophylactic measures was carried out in 32 pregnant women with gingivitis, aged 18 to 35 years. The efficiency of the treatment was assessed by the dynamics of the clinical picture, the index assessment of an oral hygiene and the periodontium condition in each trimester of pregnancy. Results: According to the data of performed observations, the high efficiency of the proposed treatment scheme is shown: 84.4% in the main group versus 46.9% in the control group. It has been clinically proven that the proposed scheme of inflammatory periodontal diseases treatment in terms of therapeutic efficiency exceeds the generally accepted basic treatment. Conclusions:The use of the proposed complex of therapeutic and prophylactic measures in the main group of patients contributed to the elimination of the inflammatory process in the periodontal tissues, suspended the progression of existing diseases, made it possible to prevent the emergence of new nosological forms, improved the condition of the oral hygiene, which makes it possible to recommend it for treatment of periodontal diseases in pregnant women.

Diagnostic information content of indicators of cytokine profile of gingival fluid in pregnant women with iron deficiency anemia

Relevance. Modern literature and clinical dental practice do not provide enough information about the value of local immunity parameters for early diagnosis of inflammatory periodontal diseases in pregnant women with iron deficiency anemia. Conventional anti-inflammatory medications used to treat inflammatory periodontal disease are frequently contraindicated during pregnancy. It is important to make a reasonable choice of safe medications, prevention methods, and treatment at early stages of inflammatory periodontal diseases in pregnant women with iron deficiency anemia. The aim of the present study is to determine informative cytokine levels in gingival fluid for early diagnosis of inflammatory periodontal disease and evaluation of effectiveness of “Lysobact” medication in pregnant women with iron deficiency anemia (IDA).Materials and methods. Cytokine levels (IL-8, IL-10; IgA, IgG) in gingival crevicular fluid were investigated in 46 pregnant women aged 18-35: among them 16 (n = 16) had mild IDA (D50), 15 (n = 15) didn't have IDA, 15 (n = 15) were non-pregnant controls. «Lysobact» (Reg. #ПN0179/01-2002) was used in pregnant women with IDA; conventional antiinflammatory therapy was used to treat pregnant women without IDA, before and after drug therapy (8-10 days) according to clinical examinations.Results. There was determined diagnostic value of cytokine levels (IgA, IgG; IL-8, IL-10) that are of great importance for early diagnosis, evaluation of the course of the disease and effectiveness of “Lysobact” immunomodulating drug, and that significantly increase in pregnant women with IDA (IL-10 from 0.010 [1.790] to 3.050 [8.550] ng/ml) versus pregnant women without IDA (from 0.001 [1.259] to 2.900 [18.640] ng/ml) in comparison with controls (4.5 [1.13] ng/ml).Conclusion. Clinical laboratory results in pregnant women with inflammatory periodontal disease allowed to determine diagnostic value of gingival crevicular fluid parameters (sIgA, IgG; IL-8, IL-10) that are related to clinical periodontal index levels, and are informative non-invasive method and are of practical importance for early diagnosis of inflammatory periodontal disease and effectiveness of “Lysobact” drug in pregnant women with iron deficiency anemia.

An accuracy study of the clinical diagnosis of periodontitis in pregnant women.

There exists a diverse range of criteria used in epidemiological studies for the diagnosis of periodontitis. The results from these studies should be evaluated with consideration to the diagnostic criteria used, and this may account for differences between studies especially in some population groups such as pregnant females. The objective is to evaluate the diagnostic criteria used in a variety of epidemiologic studies of periodontitis in pregnant females. An accuracy study with cross-sectional design was performed out from a database of 671 pregnant females, using six different sets of criteria for the diagnosis of periodontitis. Women were classified for periodontitis, as follows: Center for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP, 2012 criterion), the gold standard, Gomes-Filho etal.(2018) criterion, Albandar etal.(2007) criterion, Bassani etal.(2007) criterion, López etal.(2002) criterion, and Nesse etal.(2008) criterion. For comparison amongst the gold standard and the other criteria, sensitivity, specificity, predictive values, and likelihood ratio were determined. The frequency of periodontitis ranged from 25.0% to 90.2%. The Bassani etal. (2007) criterion was found to be more sensitive among the studies, and thus more suitable for diagnostic screening studies. Gomes-Filho etal.(2018), Albandar etal. (2007), López etal. (2002), and Nesse etal. (2008) criteria were considered more specific, which makes them more useful for studies of periodontitis with the aim of using diagnosis for confirmation of disease. A variation in the occurrence of periodontitis was observed. The criterion must be chosen according to the research aims and population characteristics.

Do the clinical criteria used to diagnose periodontitis affect the association with prematurity?

In recent years, several studies have examined the possible relationship between periodontal disease in pregnant women and preterm birth. One of the difficulties facing these studies is the heterogeneity of the clinical criteria used to define periodontitis. The aim of this cross-sectional study was to determine the degree of association between maternal periodontitis and preterm birth according to different consensus definitions of periodontal disease. In a study of 146 mothers (60 with preterm births and 86 with term deliveries) at the Sant Joan de Déu Maternal and Children's Hospital in Barcelona, a periodontal examination was carried out within 2 days of birth and the presence of periodontal disease was evaluated using the main clinical classifications published in the literature. The prevalence of periodontitis ranged from 25.4 to 52.1%, depending on the criteria used for its definition. Using the most restrictive criteria, pregnant women with periodontitis had a higher risk of preterm birth (OR: 7.49; p < 0.001) and premature rupture of membranes (OR: 2.49; p = 0.017). Premature infants born to mothers with periodontitis presented a tendency toward low weight, adjusted for gestational age (OR: 3.32; p = 0.065). Our findings suggest that the association between periodontitis and preterm birth is influenced by the definitions of periodontitis used.

Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis.

This work analyzed the available evidence in the scientific literature about the risk of preterm birth and/or giving birth to low birth weight newborns in pregnant women with periodontal disease. A systematic search was carried out in three databases for observational cohort studies that related periodontal disease in pregnant women with the risk of preterm delivery and/or low birth weight, and that gave their results in relative risk (RR) values. Eleven articles were found, meeting the inclusion criteria. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67 (1.17–2.38), 95% confidence interval (CI)), and low birth weight (RR = 2.53 (1.61–3.98) 95% CI). When a meta-regression was carried out to relate these results to the income level of each country, statistically significant results were also obtained; on the one hand, for preterm birth, a RR = 1.8 (1.43–2.27) 95% CI was obtained and, on the other hand, for low birth weight, RR = 2.9 (1.98–4.26) 95% CI. A statistically significant association of periodontitis, and the two childbirth complications studied was found, when studying the association between these results and the country’s per capita income level. However, more studies and clinical trials are needed in this regard to confirm the conclusions obtained.

Adherence to and acceptability of three alcohol-free, antiseptic oral rinses: A community-based pilot randomized controlled trial among pregnant women in rural Nepal.

ObjectivesAntiseptic oral rinses have been evaluated as interventions to reduce the risk of adverse pregnancy outcomes associated with periodontal disease in pregnant women. Oral rinse use is not common in Nepal or other countries in South Asia, where the prevalence of adverse pregnancy outcomes is high. Understanding whether pregnant women in rural communities in this region would incorporate rinse use into their daily teeth cleaning routine is an important prerequisite to future research on this topic in South Asia.MethodsWe conducted a community‐based pilot randomized controlled trial of three alcohol‐free, antiseptic oral rinses among pregnant women <22 weeks pregnant in rural Nepal with the aim of assessing rinse acceptability, adherence, and effect on clinical periodontal measures. At baseline, participants underwent a clinical periodontal examination, and then were classified as healthy or having at least mild gingivitis (≥1 site with probing depth (PD) 3 mm and bleeding on probing (BOP) or ≥4 mm (PD)). Participants were stratified by periodontal status and randomized within each exposure category to chlorhexidine (CHX) (0.12%), cetylpyridinium chloride (CPC) (0.05%), salt and water (NaCl), or control (no rinse). Rinse participants were followed weekly for 12 weeks, and all participants underwent a second periodontal examination and answered a questionnaire.ResultsPregnant women in the rural Terai region of Nepal showed high adherence to (mean weekly rinse use: 185 mL (standard deviation: 66 mL)) a recommended 210 mL and acceptability of all three rinses. Participants reported greater frequency of tooth brushing with toothpaste and improvements in other recommended oral hygiene behaviours. CHX significantly reduced rates of gingivitis (defined as a participant with BOP ≥ 10% of sites) and the extent of BOP (gingivitis at the end of follow‐up for CHX vs control: RR 0.37, 95% CI: 0.16, 0.84). CPC and NaCl rinse groups had rates of gingivitis and extent of BOP similar to the control group (gingivitis at the end of follow‐up for CPC: RR 0.81, 95% CI: 0.47, 1.38; NaCl: RR 0.92, 95% CI: 0.55, 1.56).ConclusionsAdherence to and acceptability of three alcohol‐free, antiseptic oral rinses were high among pregnant women in rural Nepal. Among participants with mild gingivitis at baseline, CHX rinse was most effective at reducing signs of disease compared to the control group. Oral rinse should be considered as a supplement to current oral self‐care routines for pregnant women in settings where rinse use is uncommon and access to oral health services is limited.

FEATURES OF MICROBIOLOGICAL AND IMMUNE STATE IN PREGNANT WOMEN WITH INFLAMMATORY PERIODONTAL DISEASES AGAINST THE BACKGROUND OF GESTATIONAL DIABETES MELLITUS

90 pregnant women with inflammatory periodontal diseases, aged 27 to 35 years were examined. The main group consisted of 60 pregnant women with gestational diabetes mellitus and the control one consisted of 30 patients with physiological pregnancy. All patients were examined before providing treatment and preventive measures at 14-15 weeks of pregnancy and after them at 37-38 weeks. Studies have shown deterioration in periodontal health, oral hygiene and increase in contamination of the oral cavity in patients of the main group as compared with patients of the control group. The use of the anti-inflammatory succinic acid based preparation is effective for inflammatory periodontal diseases in pregnant women with gestational diabetes. The improvement of periodontal tissues health was confirmed by the posttreatment indices of hygiene, immunoglobulins, microbiocenosis and periodontal indices that promote normalization of the oral cavity.

Relationship between periodontal disease and preterm birth. A systematic review and meta-analysis.

Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, it affects around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators. Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies. Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results. There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.

Evaluation of a new mouthwash formulated with Chlorhexidine and Cymenol after a scaling and root planing treatment in grade I and II periodontal patients.

Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, severe periodontal disease will affect around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators. Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies. Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results. There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.

An Evaluation of Knowledge, Attitude, and Practices of Obstetricians and Midwives Concerning Oral Health of Pregnant Women in Birjand in 2019

Background: Periodontal disease in pregnant women usually occurs due to physiological changes during pregnancy and is associated with adverse prenatal and perinatal outcomes. However, pregnant women are reluctant to visit a dentist because of unreliable information or perceived hazards of dental procedures for the mother and fetus. Therefore, it is vital to examine the knowledge and practice of obstetricians and midwives and their attitude towards oral health of pregnant women as they are closely connected with these women. Methods: In this study, 90 obstetricians and midwives from Birjand were randomly selected. The data for their knowledge, attitude, and practice were collected through self-report. The scale developed by Malek Mohammadi et al, with a high reliability of 80%, was used for data collection. Data analysis was performed using SPSS version 22.0. Results: Most of the participants (65.6%) worked in the hospital setting, and an average period of 10.32±8.24 years had passed from the subjects’ graduation. Of them, 82.2% provided care services for more than 40 hours per week for an average number of 31.3±67.6 patients. The mean score of knowledge, attitude, and practice were 6.27±1.33, 19.43±2.10, and 4.32±1.35, respectively. All participants considered it important to observe oral health during pregnancy, and 91.1% referred their patients to the dentist. Most of the participants (37.78%) obtained their information from continuous medical education programs. Conclusions: The results of this survey showed that the attitude and practice of obstetricians and midwives were satisfactory given their level of knowledge about the importance of oral health during pregnancy. However, they were still far from standard guidelines. Therefore, it is recommended that their knowledge and skills should be increased to obtain optimal care during pregnancy.

Obesity and periodontitis are not associated in pregnant women.

The objective of this study was to investigate an association between obesity (exposure) and periodontitis (outcome) in pregnant women. This association was investigated and only five studies were identified as showing a positive association. However, some of these studies had limitations such as reduced sample sizes, inadequate exposure criteria and outcome measures, which question the internal validity of these investigations. A cross-sectional study was carried out with a sample of 644 pregnant women of the public health service of the municipality of Santo Antônio de Jesus, Bahia, Brazil. Data were obtained by collecting of socioeconomic-demographic information, health behavior, health conditions, and reproductive history through an interview. Obesity was evaluated using body mass index adjusted for gestational age and expected weight gain. The diagnosis of periodontitis followed two criteria: (a) Center for Disease Prevention and Control and American Academy of Periodontology (CDC/AAP); (b) Gomes-Filho et al (2018) using criterion that also evaluated bleeding upon probing; Prevalence ratios and respective 95% confidence intervals were obtained by Poisson regression analysis. In accordance with the outcome diagnostic criterion, the frequency of periodontitis was 17.24% (Gomes-Filho et al) and 66.92% (CDC/AAP). The participants were classified as low weight (19.72%), adequate weight (42.39%), overweight (24.84%), and obesity (13.04%), based on the exposure diagnostic criterion. The low weight and overweight groups were excluded from the data analysis, giving a final sample of 357 pregnant women. The association between obesity in pregnant women and periodontitis was not statistically significant, after adjusting for confounders such as age, schooling level, alcoholic beverage consumption, alimentary and nutritional orientation, urinary infection, and dental flossing. The findings showed a high frequency of periodontitis, obesity, and overweight in the studied population but no association between obesity and periodontitis in pregnant women was found.