Jacob Pulikottil Shaju, Nath Sonia
Department of Clinical Dentistry, International Medical University School of Dentistry, Kuala Lumpur, Malaysia.
Department of Periodontology, Vananchal Dental College and Hospital, Garhwa, India.
J Periodontal Implant Sci. 2014 Apr;44(2):85-93. doi: 10.5051/jpis.2014.44.2.85. Epub 2014 Apr 24.
Low birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies.
A hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ≥2,500 g. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth.
LBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2).
Periodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.
低出生体重（LBW）是印度主要的公共卫生问题之一。因此，有必要识别出那些经改善后可减轻医疗系统中不健康儿童负担的风险因素。本研究的目的是确定印度农村人口中母亲患牙周炎是否为低出生体重婴儿的一个风险因素。
在340名产后母亲中开展了一项基于医院的病例对照研究。病例组由170名生育体重<2500克婴儿的女性组成，而对照组由170名生育体重≥2500克婴儿的女性组成。母亲的详细信息取自医院记录并通过个人访谈获取，产后进行了全口牙周检查，包括每颗牙齿六个位点的探诊深度、临床附着水平和探诊出血情况。
低出生体重病例的牙周状况明显比对照组差，优势比（OR）为2.94（P = 0.01）。多因素逻辑回归模型表明，牙周疾病是一个显著的独立风险因素，低出生体重组的调整优势比（aOR）为2.85（95%置信区间[CI]，1.62 - 5.5）。与低出生体重有显著关联的其他因素包括子痫前期（aOR，4.49；95% CI，1.4 - 14.7）、早产（aOR，5.5；95% CI，3.2 - 9.9）和阴道分娩类型（aOR，2.74；95% CI，1.4 - 5.2）。
牙周炎是低出生体重的一个强有力、独立且具有临床意义的风险因素。牙周治疗应成为印度农村妇女产前预防保健的一部分。
