Azofeifa Alejandro, Yeung Lorraine F, Alverson C J, Beltrán-Aguilar Eugenio
Division of Evaluation, Analysis and Quality, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.
Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
J Public Health Dent. 2016 Sep;76(4):320-329. doi: 10.1111/jphd.12159. Epub 2016 May 6.
This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004).
Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons.
In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income.
Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve women's oral health outcomes.
本研究利用美国国家健康与营养检查调查（NHANES，1999 - 2004年）的数据，评估并比较了育龄期（15 - 44岁）孕妇与非孕妇的龋齿患病率及严重程度，以及牙周疾病的患病率。
估计值来自897名孕妇和3971名非孕妇的样本。使用卡方检验和双样本t检验评估按年龄、种族/族裔、教育程度和贫困状况分层的组间差异。采用Bonferroni方法对多重比较进行校正。
总体而言，孕妇与非孕妇在龋齿和牙周疾病患病率估计值上无统计学显著差异。然而，按社会人口学特征分层时结果显示出显著差异。例如，15 - 24岁女性中，孕妇未经治疗的龋齿患病率显著高于非孕妇（41%对24%，P = 0.001）。无论妊娠状态如何，与非西班牙裔白人或教育程度较高或家庭收入较高的相应参照组相比，少数族裔或教育程度较低或家庭收入较低的女性未经治疗的龋齿患病率、龋齿严重程度及牙周疾病患病率更高。
本研究结果表明，孕妇与非孕妇在龋齿和牙周疾病方面临床差异不大，但在社会人口学特征方面存在持续差异。为减少美国口腔健康差异，尤其重要的是改善弱势群体获得口腔保健的机会。将口腔健康纳入整体医疗保健可使女性受益并改善其口腔健康状况。
