Periodontal Treatment and Pregnancy Outcomes: Preliminary Assessment of Racial Disparities

Methods: The data source was the medical and dental claims database of a large national health insurer. Claims of fully insured female enrollees participating in medical and dental insurance plans delivering live births from singleton pregnancies between January 1, 2003 and September 30, 2006 were examined. The outcome variables were low birthweight and preterm delivery. The primary exposure variable had five categories: periodontal treatment pre-, during, and post- gestation, non-periodontal treatment pre-gestation, and no dental treatment. Secondary variables were maternal age at delivery, presence of pregnancy complications, number of residence relocations, and duration of continuous dental coverage. Proxy demographic information was generated for race and income by matching the enrollee zip code of primary residence to 2000 U.S. Census data. Data analyses were used to characterize the study cohort; assess the impact of race on low birthweight and preterm birth, while adjusting for secondary variables.

Results: Exclusion criteria resulted in a sample of 6,214. 4.2 % of birth outcomes were low birthweight and 9.3% were preterm deliveries. 6% of the sample resided in zip codes where black population was 0%; 59% with 1-10% black population; 22% with 10-35% black population; 3% with 35-50% black population; and 10% with 50-100% black population. For low birthweight (aOR=1.009) and preterm delivery (aOR=1.007), residing in high black population areas was associated with increased odds of having the adverse outcome (p<0.001).

Conclusions: Findings suggest that racial disparities exist in birth outcomes in this cohort of insured women. Further study with a larger analytic sample and utilization of respondent reported race information has been proposed and will contribute to the knowledge base on race and ethnic disparities in dental service utilization and birth outcomes.