Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil.
Department of Preventive Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.
J Periodontal Res. 2020 Jan;55(1):77-84. doi: 10.1111/jre.12690. Epub 2019 Aug 12.
The objective of this study was to investigate an association between obesity (exposure) and periodontitis (outcome) in pregnant women.
This association was investigated and only five studies were identified as showing a positive association. However, some of these studies had limitations such as reduced sample sizes, inadequate exposure criteria and outcome measures, which question the internal validity of these investigations.
A cross-sectional study was carried out with a sample of 644 pregnant women of the public health service of the municipality of Santo Antônio de Jesus, Bahia, Brazil. Data were obtained by collecting of socioeconomic-demographic information, health behavior, health conditions, and reproductive history through an interview. Obesity was evaluated using body mass index adjusted for gestational age and expected weight gain. The diagnosis of periodontitis followed two criteria: (a) Center for Disease Prevention and Control and American Academy of Periodontology (CDC/AAP); (b) Gomes-Filho et al (2018) using criterion that also evaluated bleeding upon probing; Prevalence ratios and respective 95% confidence intervals were obtained by Poisson regression analysis.
In accordance with the outcome diagnostic criterion, the frequency of periodontitis was 17.24% (Gomes-Filho et al) and 66.92% (CDC/AAP). The participants were classified as low weight (19.72%), adequate weight (42.39%), overweight (24.84%), and obesity (13.04%), based on the exposure diagnostic criterion. The low weight and overweight groups were excluded from the data analysis, giving a final sample of 357 pregnant women. The association between obesity in pregnant women and periodontitis was not statistically significant, after adjusting for confounders such as age, schooling level, alcoholic beverage consumption, alimentary and nutritional orientation, urinary infection, and dental flossing.
The findings showed a high frequency of periodontitis, obesity, and overweight in the studied population but no association between obesity and periodontitis in pregnant women was found.
本研究旨在探讨孕妇肥胖（暴露因素）与牙周炎（结局）之间的关系。
该关联已被研究，仅发现五项研究显示出正相关。然而，其中一些研究存在局限性，例如样本量减少、暴露标准和结局测量不充分，这些问题质疑了这些研究的内部有效性。
本研究为一项横断面研究，样本来自巴西巴伊亚州圣安东尼奥德耶稣市公共卫生服务的 644 名孕妇。通过访谈收集社会经济人口统计学信息、健康行为、健康状况和生殖史来获取数据。肥胖通过调整孕龄和预期体重增加的体重指数来评估。牙周炎的诊断遵循以下两个标准：（a）疾病预防控制中心和美国牙周病学会（CDC/AAP）；（b）Gomes-Filho 等人（2018 年）使用的标准，该标准还评估了探诊时出血。通过泊松回归分析获得患病率比及其相应的 95%置信区间。
根据结局诊断标准，牙周炎的发生率为 17.24%（Gomes-Filho 等人）和 66.92%（CDC/AAP）。根据暴露诊断标准，参与者被分为低体重（19.72%）、体重正常（42.39%）、超重（24.84%）和肥胖（13.04%）。低体重和超重组被排除在数据分析之外，最终样本为 357 名孕妇。在校正年龄、教育程度、饮酒、饮食和营养取向、尿路感染和使用牙线等混杂因素后，孕妇肥胖与牙周炎之间无统计学关联。
研究结果显示，研究人群中牙周炎、肥胖和超重的发生率较高，但未发现孕妇肥胖与牙周炎之间存在关联。
