Janc Matevž, Tomažič Marjeta, Kanduti Domen, Skalerič Uroš, Schara Rok
Oral Health Prev Dent. 2025 Jan 30;23:93-99. doi: 10.3290/j.ohpd.c_1789.
To assess the association between periodontal health and pregnancy or delivery complications in type 1 diabetic (TIDM) and non-diabetic pregnant women.
15 TIDM and 15 non-diabetic primiparous women were enrolled in the prospective case-control study. We compared periodontal status, levels of glycosylated hemoglobin (HbA1c), gestational week of birth, birth weight of a newborn and pregnancy or delivery complications between the groups.
TIDM pregnant women gave birth statistically significantly earlier (2 weeks) (p = 0.034), but not before the 37th week of gestation. The odds ratio (OR) for pregnancy or delivery complications was ~ 5 times greater (95% CI: 1.1-26.4; p = 0.033) and for Caesarean section (C-section) ~ 6 times greater (95%CI: 1.2-30.7; p = 0.032) in TIDM group. The association between periodontal disease (PD) and pregnancy or delivery complications was not statistically significant in either group. The presence of TIDM (p = 0.002; R2 = 0.28), a higher bleeding-on-probing/full-mouth bleeding score (FMBS) (p = 0.043; R2 = 0.14), and a higher level of HbA1c (p = 0.026; R2 = 0.16) were statistically significantly more often associated with an earlier gestational week of birth. Higher levels of HbA1c were statistically significantly positively associated with a higher frequency of pregnancy or delivery complications (p = 0.024) and a higher frequency of C-section (p = 0.051).
There are strong indications that both endocrinological and periodontal therapy should form a part of preventive prenatal care.
评估1型糖尿病(TIDM)孕妇和非糖尿病孕妇的牙周健康与妊娠或分娩并发症之间的关联。
15名TIDM初产妇和15名非糖尿病初产妇参与了这项前瞻性病例对照研究。我们比较了两组之间的牙周状况、糖化血红蛋白(HbA1c)水平、出生孕周、新生儿出生体重以及妊娠或分娩并发症。
TIDM孕妇分娩时间在统计学上显著提前(2周)(p = 0.034),但未在妊娠37周前分娩。TIDM组妊娠或分娩并发症的优势比(OR)约高5倍(95%置信区间:1.1 - 26.4;p = 0.033),剖宫产(C-section)的优势比约高6倍(95%置信区间:1.2 - 30.7;p = 0.032)。牙周疾病(PD)与妊娠或分娩并发症之间的关联在两组中均无统计学意义。TIDM的存在(p = 0.002;R2 = 0.28)、更高的探诊出血/全口出血评分(FMBS)(p = 0.043;R2 = 0.14)以及更高的HbA1c水平(p = 0.026;R2 = 0.16)在统计学上更常与更早的出生孕周相关。更高的HbA1c水平在统计学上与更高的妊娠或分娩并发症发生率(p = 0.024)和更高的剖宫产发生率(p = 0.051)呈显著正相关。
有充分迹象表明,内分泌治疗和牙周治疗都应成为预防性产前护理的一部分。