母亲体重过重、妊娠晚期牙周炎与婴儿出生时健康状况的关联。
Association between excessive maternal weight, periodontitis during the third trimester of pregnancy, and infants' health at birth.
机构信息
Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil.
Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Ciências Fisiológicas, área de Farmacologia, Piracicaba, São Paulo, Brasil.
出版信息
J Appl Oral Sci. 2020 Mar 27;28:e20190351. doi: 10.1590/1678-7757-2019-0351. eCollection 2020.
INTRODUCTION
Excessive weight is associated with periodontitis because of inflammatory mediators secreted by the adipose tissue. Periodontal impairments can occur during pregnancy due to association between high hormonal levels and inadequate oral hygiene. Moreover, periodontitis and excessive weight during pregnancy can negatively affect an infant's weight at birth.
OBJECTIVE
This observational, cross-sectional study aimed to evaluate the association between pre-pregnancy overweight/obesity, periodontitis during the third trimester of pregnancy, and the infants' birth weight.
METHODOLOGY
The sample set was divided into 2 groups according to the preconception body mass index: obesity/overweight (G1=50) and normal weight (G2=50). Educational level, monthly household income, and systemic impairments during pregnancy were assessed. Pocket probing depth (PPD) and clinical attachment level (CAL) were obtained to analyze periodontitis. The children's birth weight was classified as low (<2.5 kg), insufficient (2.5-2.999 kg), normal (3-3.999 kg), or excessive (≥4 kg). Bivariate analysis (Mann-Whitney U test, t-test, chi-squared test) and logistic regression (stepwise backward likelihood ratio) were performed (p<0.05).
RESULTS
G1 showed lower socioeconomic levels and higher prevalence of arterial hypertension and gestational diabetes mellitus during pregnancy than G2 (p=0.002). G1 showed higher means of PPD and CAL (p=0.041 and p=0.039, respectively) and therefore a higher prevalence of periodontitis than G2 (p=0.0003). G1 showed lower infants' birth weight than G2 (p=0.0004). Excessive maternal weight and educational levels were independent variables associated with periodontitis during the third trimester of pregnancy (X2[2]=23.21; p<0.0001). Maternal overweight/obesity was also associated with low/insufficient birth weight (X2[1]=7.01; p=0.008).
CONCLUSION
The present findings suggest an association between excessive pre-pregnancy weight, maternal periodontitis, and low/insufficient birth weight.
简介
由于脂肪组织分泌的炎症介质，超重与牙周炎有关。由于高激素水平与口腔卫生不足之间的关联，怀孕期间可能会出现牙周损伤。此外，怀孕期间的牙周炎和超重会对婴儿的出生体重产生负面影响。
目的
本观察性、横断面研究旨在评估妊娠晚期孕前超重/肥胖、牙周炎与婴儿出生体重之间的关系。
方法
根据孕前体重指数（BMI）将样本分为两组：肥胖/超重组（G1=50）和正常体重组（G2=50）。评估了教育水平、月家庭收入和怀孕期间的系统性疾病。测量了牙周袋探诊深度（PPD）和临床附着水平（CAL）以分析牙周炎。将儿童的出生体重分为低（<2.5kg）、不足（2.5-2.999kg）、正常（3-3.999kg）和过多（≥4kg）。进行了双变量分析（Mann-Whitney U 检验、t 检验、卡方检验）和逻辑回归（逐步向后似然比）（p<0.05）。
结果
与 G2 相比，G1 显示出较低的社会经济水平以及更高的妊娠期高血压和妊娠期糖尿病患病率（p=0.002）。G1 的 PPD 和 CAL 均值更高（p=0.041 和 p=0.039），因此 G1 比 G2 更易发生牙周炎（p=0.0003）。G1 的婴儿出生体重低于 G2（p=0.0004）。超重/肥胖和教育水平是妊娠晚期牙周炎的独立变量（X2[2]=23.21；p<0.0001）。母亲超重/肥胖也与低/不足出生体重相关（X2[1]=7.01；p=0.008）。
结论
本研究结果表明，孕前体重过重、产妇牙周炎与低/不足出生体重之间存在关联。
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