Associação entre o nascimento de bebês pré-termos e/ou com baixo peso e a doença periodontal materna: um estudo caso-controle na cidade de Pelotas-RS

Abstract

The association between maternal periodontal disease and adverse perinatal outcomes, grounded by theoretical models, although extensively studied remains unclear. The aim of this study is to evaluate, by a case-control study, conducted in three hospitals in Pelotas city, Rio Grande do Sul, Brazil, the association between preterm birth and/or low birth weight (PTB/LBW) and clinical parameters of maternal periodontal disease. Postpartum women who gave birth to a newborn PTB/LBW (case group), and postpartum women who had babies at full term with normal weight (control group) were included, in the ratio 1:2. Data were collected through medical records (identification, medications, baby birth), interview (age, skin color, education, income, marital status, occupation, height and weight before pregnancy, smoking, alcohol consumption, number of prenatal visits, oral hygiene habits), and clinical (active caries lesion, simplified dental plaque index, probing depth (PD), clinical attachment level (CAL)). Bivariate analysis was performed to assess the proportion PTB/LBW in the independent variables and multiple logistic regression analysis to assess the association between adverse perinatal outcomes and independent variables. The sample consisted of 140 cases and 276 controls. By the 140 postpartum women with PTB/LBW in case group, 119 (85%) had preterm birth, 93 (66.4 %) low birth weight babies and 72 (51.4 %) had both conditions. The presence of generalized periodontitis was not associated to any adverse pregnancy outcomes. For the periodontal status, there was no association with PTB/LBW, PTB and with BPN, NPTPB the p values were conflicting with the confidence interval. The PTB/LBW was significantly associated with income between 1.5-2.9 and ≥ 3 minimum wage (OR=1.84 (1.09 to 3.09), OR=1.89 (1.07 - 3.35), respectively), adequate number of prenatal visits (OR=0.26 (0.13 - 0,50)), history of PTB/LBW (OR = 2.16 (1.27 - 3,65)), systemic disease (OR=1.70 (0.88 to 3.29)), cesarean delivery (OR = 1.83 (1.20-2.77 )) and pre-eclampsia (OR= 5.26(2.43- 11.4)). Postpartum women with larger income, older, with previous PTB/LBW had a higher risk for PTB. Previous systemic disease was associated with PTB/LBW, PTB and NPTBP. It can be conclude that, in this sample, the clinical parameters of periodontitis were not considered a risk factor for the studied adverse perinatal outcomes.