Harjunmaa Ulla, Järnstedt Jorma, Alho Lotta, Dewey Kathryn G, Cheung Yin Bun, Deitchler Megan, Ashorn Ulla, Maleta Kenneth, Klein Nigel J, Ashorn Per
Department for International Health, University of Tampere School of Medicine, Tampere, Finland.
Department of Radiology, Medical Imaging Center, Tampere University Hospital, Tampere, Finland.
Trop Med Int Health. 2015 Nov;20(11):1549-1558. doi: 10.1111/tmi.12579. Epub 2015 Aug 18.
Maternal infections are associated with intrauterine growth restriction (IUGR) and preterm birth (PTB). Dental infections are common in low-income settings, but their contribution to adverse pregnancy outcomes is unknown. We studied the epidemiology of dental periapical infections among pregnant women and their association to foetal growth restriction and the duration of pregnancy in a rural sub-Saharan African population.
This was a cross-sectional study on the association between maternal dental periapical infections and birth outcomes, in Malawi, Africa. We assessed oral health clinically and radiologically among recently delivered women with known duration of pregnancy and measured birthweight (BW), length and head circumference of their infants.
Of 1024 analysed participants, 23.5% had periapical infections. Mean duration of pregnancy was 39.4 weeks, BW 2979 g and length 49.7 cm. Women with periapical infection had mean (95% CI) pregnancy duration 0.4 weeks (0.1-0.8) shorter and delivered infants with 79 g (13-145) lower BW and 0.5 cm (0.2-0.9) shorter neonatal length than women without periapical infection. The incidence of PTB was 10.0% among women with periapical infection and 7.3% among those without (adjusted difference 3.5%, 95% CI -1.1-8.1%). Corresponding prevalences for stunting were 20.9% and 14.2% (adjusted difference 9.0%, 95% CI 2.7%-15.2%). The population-attributable risk fraction attributable to periapical infection was 9.7% for PTB and 12.8% for stunting.
Periapical infection was associated with shorter pregnancy duration and IUGR in the study area; interventions addressing this risk factor may improve birth outcomes in low-income settings.
孕产妇感染与宫内生长受限（IUGR）和早产（PTB）有关。牙齿感染在低收入环境中很常见，但其对不良妊娠结局的影响尚不清楚。我们研究了撒哈拉以南非洲农村地区孕妇牙齿根尖周感染的流行病学及其与胎儿生长受限和妊娠持续时间的关系。
这是一项关于非洲马拉维孕产妇牙齿根尖周感染与分娩结局之间关联的横断面研究。我们对近期分娩且已知妊娠持续时间的妇女进行了临床和放射学口腔健康评估，并测量了其婴儿的出生体重（BW）、身长和头围。
在1024名分析对象中，23.5%患有根尖周感染。平均妊娠持续时间为39.4周，出生体重2979克，身长49.7厘米。与无根尖周感染的妇女相比，有根尖周感染的妇女平均（95%CI）妊娠持续时间短0.4周（0.1 - 0.8），分娩的婴儿出生体重低79克（13 - 145），新生儿身长短0.5厘米（0.2 - 0.9）。根尖周感染妇女的早产发生率为10.0%，无根尖周感染妇女为7.3%（调整差异3.5%，95%CI - 1.1 - 8.1%）。相应的发育迟缓患病率分别为20.9%和14.2%（调整差异9.0%，95%CI 2.7% - 15.2%）。根尖周感染导致的人群归因风险分数，早产为9.7%，发育迟缓为12.8%。
在研究地区，根尖周感染与较短的妊娠持续时间和宫内生长受限有关；针对这一风险因素的干预措施可能改善低收入环境中的分娩结局。
