Oral Health and adverse pregnancy outcome. A multicentric epidemiological study

Objectives: An association among periodontal disease and adverse pregnancy outcome was proposed. Our aim was to determine the relationship between dental-periodontal health in postpartum women and adverse obstetric outcomes. Methods: 225 women were examined postpartum at bedsite (≤5-days since delivery), through a standardised questionnaire and a full dental/periodontal examination; DMFT and PSR and obstetric data were recorded. Cases (n=40) had Preterm Delivery (PD, <37 weeks of gestation) and/or delivered, Small for gestational age (SGA), newborns (birthweight <10° centile) and/or Preeclampsia (PE/PIH) or PROM. Controls (n=185) had normal pregnancies, delivered at/or around term and newborns with normal weights. Association between clinical index registrations and questionnaire data were estimated with Pearson correlation coefficients, Χ² test for trends, factor analysis using the Principal Components for self-perceived oral attitudes, and stepwise logistic regression. Results: Cases and controls did not differ in mean age, birthplace, ethnicity, education and smoking habits. Cases were: PD=15, SGA=12, PE/PIH=8 PROM=8. Oral hygiene habits and periodontal subjective complaints during pregnancy were similar in the two groups. Three main behavioural factors (smoking, oral hygiene and toothbrushing habits) resulted as relevant to the oral health status in the immediate postpartum period. Logistic models were statistically significant but no one of the covariates was. A moderately significant association was observed regarding cases and level of periodontal disease (Χ² for trend=4.07 p=0.04), while a higher mean proportion of sites probing more than 4 mm was observed in the case-group but not statistical significant. Conclusions: Our study failed to demonstrate a relationship between periodontal disease and adverse pregnancy outcomes. However, our population is different from previously studies in both demographic factors and the level of periodontal disease. This report focus on the role of oral hygienic and behavioural habits as determinants of oral health status but failed to observe correlation with the clinical parameters evaluated.