Department of Periodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, 22 ZhongguancunNandajie, Haidian District, Beijing, 100081, China.
BMC Oral Health. 2024 Aug 4;24(1):891. doi: 10.1186/s12903-024-04640-9.
Periodontitis is associated with poor pregnancy outcomes, indicating periodontal health as an important health concern for pregnant women. Herein, this study identified risk indicators for periodontitis and developed a nomogram for predicting the risk of periodontitis in pregnancy by analyzing periodontitis and associated factors in pregnant women.
A community-based cross-sectional study was conducted by including 438 pregnant women at 10-36 gestational weeks from Langfang, China. Pregnant women were examined for periodontal status, and their demographic, socioeconomic, and oral health behavior data were collected. Potential influencing factors of periodontitis were analyzed with univariate and multivariate logistic regression analyses. A nomogram was developed, followed by the assessment of its validation and discriminatory abilities.
The prevalence of periodontitis was 59.8% in pregnant women. Periodontitis-associated variables in pregnant women were gestational age, non-first pregnancy, daily tooth brushing frequency of ≤ 1 before pregnancy, and annual frequency of periodontal treatment < 1 (including no periodontal treatment). The risk of periodontitis was positively associated with gestational age (OR = 1.28, 95% CI = 1.17-1.39, p < 0.001). Pregnancy history showed a strong positive association (OR = 6.57, 95% CI = 1.22-35.43, p = 0.03). Daily tooth brushing frequency before pregnancy was also positively associated with periodontitis (OR = 1.54, 95% CI = 1.03-2.79, p = 0.05). Additionally, the annual frequency of periodontal treatment exhibited a positive association, with higher odds observed for those with less frequent treatment (OR = 2.28, 95% CI = 1.25-4.14, p = 0.05; OR = 7.37, 95% CI = 3.04-22.06, p < 0.001). These four factors were used to develop a nomogram for predicting periodontitis in pregnant women. The area under the receiver operating characteristic curve of the nomogram was 0.855 and 0.831 in the training and testing cohorts, respectively, reflecting the superior prediction accuracy of the nomogram. The calibration curve and decision curve analysis demonstrated the good performance and net benefit of the nomogram.
Risk factors for periodontitis in pregnant Chinese women include gestational age, non-first pregnancy, lower frequency of daily tooth brushing before pregnancy, and lower frequency of periodontal treatment. An easy-to-use nomogram with acceptable accuracy can allow for the prediction of periodontitis risk in pregnant Chinese women.
With the assistance of this nomogram, clinicians can evaluate the risk of periodontitis in pregnancy, thereby offering more tailored oral health education to women of reproductive age.
牙周炎与不良妊娠结局相关，表明牙周健康是孕妇的重要健康关注点。本研究通过分析孕妇的牙周炎及相关因素，确定牙周炎的风险指标，并建立预测孕妇牙周炎风险的列线图。
采用基于社区的横断面研究，纳入来自中国廊坊的 438 名 10-36 孕周的孕妇。对孕妇进行牙周状况检查，并收集其人口统计学、社会经济和口腔健康行为数据。采用单因素和多因素 logistic 回归分析牙周炎的潜在影响因素。建立列线图，评估其验证和区分能力。
孕妇中牙周炎的患病率为 59.8%。孕妇中与牙周炎相关的变量包括孕周、非初产妇、妊娠前每日刷牙频率≤1 次和每年牙周治疗频率<1（包括无牙周治疗）。牙周炎的发病风险与孕周呈正相关（OR=1.28，95%CI=1.17-1.39，p<0.001）。妊娠史呈强正相关（OR=6.57，95%CI=1.22-35.43，p=0.03）。妊娠前每日刷牙频率也与牙周炎呈正相关（OR=1.54，95%CI=1.03-2.79，p=0.05）。此外，牙周治疗的年频率呈正相关，治疗频率较低的患者发病风险更高（OR=2.28，95%CI=1.25-4.14，p=0.05；OR=7.37，95%CI=3.04-22.06，p<0.001）。这四个因素被用于建立预测孕妇牙周炎的列线图。列线图在训练队列和测试队列中的受试者工作特征曲线下面积分别为 0.855 和 0.831，反映了列线图具有较高的预测准确性。校准曲线和决策曲线分析表明该列线图具有良好的性能和净收益。
中国孕妇牙周炎的危险因素包括孕周、非初产妇、妊娠前每日刷牙频率较低和牙周治疗频率较低。一个易于使用且具有可接受准确性的列线图可以预测中国孕妇牙周炎的风险。
借助该列线图，临床医生可以评估孕妇患牙周炎的风险，从而为育龄妇女提供更有针对性的口腔健康教育。
