Clinical risk factors associated with incidence and progression of periodontal conditions in pregnant women.

OBJECTIVES Few large studies have investigated the progression of periodontal conditions during pregnancy in a comprehensive manner. This study aimed to identify clinical factors that were predictive of incidence/progression of periodontal measures in pregnant women adjusting for relevant predictors. MATERIAL AND METHODS Periodontal examinations were conducted on 891 pregnant women prior to 26 weeks gestational age and within 48 h after delivery. Gingivitis/periodontitis incidence/progression (GPIP) was defined as four plus sites with 2+ mm increase in probing depth (PD) that resulted in PD of at least 4 mm at delivery. Multivariable models including relevant clinical variables and significant covariates were developed. RESULTS While several clinical measures were significantly associated with the outcome, having >/=10% of sites with bleeding on probing (BOP) and four plus sites with PD >/=4 mm (PD4) were the best two predictors of GPIP (odds ratio (OR)=2.8, 95% confidence interval (CI)=1.8-4.2; OR=2.0, 95% CI=1.4-2.9, respectively), adjusting for maternal race, age, enrollment weight, smoking during pregnancy, marital status, food stamp eligibility, and private health insurance. Multivariable models assessed the impact of BOP on the PD4-GPIP relationship. PD4 was significant in the presence of BOP (low BOP OR=1.3, 95% CI=0.5-3.3; high BOP OR=3.0, 95% CI=2.2-4.3). CONCLUSIONS Enrollment BOP and PD4 were significant predictors of PD in pregnant women, however; PD4 is only a predictor with BOP.

[1]  S. Offenbacher,et al.  Periodontitis is associated with pregnancy complications , 2006, British Dental Journal.

[2]  J. Beck,et al.  The oral conditions and pregnancy study: periodontal status of a cohort of pregnant women. , 2004, Journal of periodontology.

[3]  J. Hauth,et al.  Periodontal disease and preterm birth: results of a pilot intervention study. , 2003, Journal of periodontology.

[4]  A. Batieha,et al.  The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables. , 2003, Journal of oral rehabilitation.

[5]  J. Beck,et al.  Maternal Periodontal Disease Is Associated With an Increased Risk for Preeclampsia , 2003, Obstetrics and gynecology.

[6]  A. Dasanayake,et al.  Preterm low birth weight and periodontal disease among African Americans. , 2003, Dental clinics of North America.

[7]  J. Beck,et al.  Relationships among clinical measures of periodontal disease and their associations with systemic markers. , 2002, Annals of periodontology.

[8]  Patricio C. Smith,et al.  Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. , 2002, Journal of periodontology.

[9]  M. Curtis,et al.  Maternal Periodontal Disease and Preterm Low Birthweight: Case-Control Study , 2002, Journal of dental research.

[10]  M. Laine Effect of pregnancy on periodontal and dental health , 2002, Acta odontologica Scandinavica.

[11]  J. Beck,et al.  Maternal periodontitis and prematurity. Part I: Obstetric outcome of prematurity and growth restriction. , 2001, Annals of periodontology.

[12]  J. Hauth,et al.  Periodontal infection and preterm birth: results of a prospective study. , 2001, Journal of the American Dental Association.

[13]  P. Papapanou,et al.  Periodontal infections and pre-term birth: early findings from a cohort of young minority women in New York. , 2001, European journal of oral sciences.

[14]  M. Soory,et al.  Periodontal disease status during pregnancy and 3 months post-partum, in a rural population of Sri-Lankan women. , 2000, Journal of clinical periodontology.

[15]  P. Bullón,et al.  The influence of general health and socio-cultural variables on the periodontal condition of pregnant women. , 1999, Journal of periodontology.

[16]  J. Beck,et al.  Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight. , 1996, Journal of periodontology.

[17]  G. Koch,et al.  Incidence of attachment loss over 3 years in older adults--new and progressing lesions. , 1995, Community dentistry and oral epidemiology.

[18]  N. Lang,et al.  Bleeding on probing. A parameter for monitoring periodontal conditions in clinical practice. , 1994, Journal of clinical periodontology.

[19]  S. Socransky,et al.  Clinical risk indicators for periodontal attachment loss. , 1991, Journal of clinical periodontology.

[20]  N. Lang,et al.  Absence of bleeding on probing. An indicator of periodontal stability. , 1990, Journal of clinical periodontology.

[21]  G. Koch,et al.  Prevalence and risk indicators for periodontal attachment loss in a population of older community-dwelling blacks and whites. , 1990, Journal of periodontology.

[22]  N. Lang,et al.  Bleeding on probing. A predictor for the progression of periodontal disease? , 1986, Journal of clinical periodontology.

[23]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[24]  D. Cohen,et al.  A longitudinal investigation of the periodontal changes during pregnancy and fifteen months post-partum. II. , 1971, Journal of periodontology.

[25]  D. Cohen,et al.  A longitudinal investigation of the periodontal changes during pregnancy. , 1969, Journal of periodontology.

[26]  H. Löe,et al.  Periodontal disease in pregnancy. 3. Response to local treatment. , 1966, Acta odontologica Scandinavica.

[27]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. , 1964, Acta odontologica Scandinavica.

[28]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. , 1963, Acta odontologica Scandinavica.

[29]  B. Orban,et al.  Gingivitis in pregnancy. , 1949, Oral surgery, oral medicine, and oral pathology.