Analyzing Dental and Medical Insurance Data to Determine Risk of Adverse Pregnancy Outcomes

Objectives: Objectives: To explore the hypothesis that maternal oral inflammation or infection is associated with increased risk for adverse pregnancy outcomes, we examined Intrauterine Growth Restriction (IUGR), Preterm Birth (PT), Premature Rupture of Membranes (PROM), and Placental Abruption (PA) in relation to oral surgical, endodontic or periodontal procedures before, during and after pregnancy.
Methods: Methods: We conducted a retrospective cohort analysis of insurance claims data from 2010 to 2013 for women who delivered a singleton live birth and had continuous dental and medical coverage for at least 24 months (n=22,085). Adverse pregnancy outcomes were examined as a function of type and timing of dental treatment, adjusting for potential confounders in logistic regression.
Results: Results: After adjusting for maternal demographic characteristics and various measures of dental treatment before during and after pregnancy, periodontal treatment in the immediate postnatal period, a marker of periodontal disease during gestation, was associated with a 43% increase in the risk of IUGR (OR: 1.43, 95%CI: 1.22,1.69). Endodontic treatment in the immediate postnatal period, a probable marker for pulpal infection and inflammation during gestation, was associated with a 22% increase in risk of IUGR (OR: 1.22, 95%CI: 1.03,1.44). Dental care during gestation was associated with a 24% reduction in the risk of IUGR (OR: 0.76, 95%CI: 0.60, 0.97). No significant associations were found between any category of dental treatment with the outcomes PA, PT or PROM.
Conclusions: Conclusions: Endodontic and periodontal treatment in the immediate postnatal period, a proxy for the presence of oral infection/inflammation during gestation, was associated with increased risk for IUGR, while any dental care received during gestation was associated with decreased risk. These findings warrant further investigation and may have implications on insurance product design.