Obesity and periodontitis are not associated in pregnant women

Abstract

Objective The objective of this study was to investigate an association between obesity (exposure) and periodontitis (outcome) in pregnant women. Background 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. Methods 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. Results 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. Conclusions 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.

Microbiological findings of the maternal periodontitis associated to low birthweight

“…However, no associations were found with respect to the presence of periodontal bacteria in the subgingival biofilm and LBW. Although these findings are in agreement with those reported by other authors, (5,10,11) some studies did detect an association between both clinical periodontitis, as well as the presence of periodontopathogens, and adverse gestational outcomes. (2,20,21) Despite this evidence surrounding the association between maternal periodontitis, as an exposure factor, and adverse gestational outcomes, the magnitude of the observed association has been modest.…”

“…However, no associations were found with respect to the presence of periodontal bacteria in the subgingival biofilm and LBW. Although these findings are in agreement with those reported by other authors, ( 5 , 10 , 11 ) some studies did detect an association between both clinical periodontitis, as well as the presence of periodontopathogens, and adverse gestational outcomes. ( 2 , 20 , 21 )…”

“…(7) Nonetheless, despite the different methods used, the prevalence of periodontal disease remains high among pregnant women. (8)(9)(10) Furthermore, the complexities involved in performing intervention studies (inappropriate timing and/or type of intervention, inclusion of patients whose risk is not modifiable, and transient bacteremia caused by periodontal treatment) warrants a more thorough understanding of the effects of treatment and improvement in periodontal health on the pathophysiology of PTB and LBW. (4) Several studies investigating the association between the presence of periodontopathogens and the risk of adverse pregnancy outcomes have been reported.…”

Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan

“…Recently, Gomes-Filho el al. reported no association between obesity and periodontal disease among pregnant women in Brazil [19]. On the other hand, Lee et al reported a significant association between obesity and periodontitis in pregnant women [26].…”

“…Likewise, Gomes-Filho el al. reported a low prevalence (17.24%) of periodontal disease among pregnant women in Brazil [19]. A slightly higher prevalence (31%) of periodontal disease was documented in pregnant women in Jordan [13].…”