Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda

Abstract

BackgroundLiterature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals.MethodsThis was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes.ResultsApproximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05).ConclusionPeriodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance.

Impact of maternal periodontitis on preterm birth and low birth weight in babies: results of a scoping review

“…This lack of an association was in agreement with Bansal and colleagues who stated that providing periodontal treatment during pregnancy may be too late to reduce the local and systemic in ammations and may be ineffective in preventing the preterm birth 22 . The other negative study ndings from the case control study in Uganda conducted by Muwazi and colleagues, was possibly limited by the use of only one group of women for a short period of time 23 . The other 13 studies retrieved did nd an association between periodontal disease and preterm birth and/or low birth weight.…”

Assessing the association between periodontitis and preterm birth : A case control study

“…Also in Africa, some studies have been done on preterm birth and low birth weight deliveries and these were signi cantly associated with poor periodontal status; for example a study done in Nigeria by Umoh and colleagues revealed that periodontal treatment was effective in preventing low birth weight deliveries 20 . In Uganda, Wandera and colleagues also found that mothers with periodontal problems and poor oral hygiene during pregnancy had a greater risk of preterm birth as opposed to mothers who did not have periodontitis during pregnancy 44 and Muwazi in Uganda in his cross-sectional study revealed the association between gingival recession and preterm birth 31 .…”

“…In this study, most of the mothers were young whereby the mean age was 27.35 (SD 5.2) ranging from 18 to 35 years and may be the reason why there was no statistical association between maternal age and preterm birth in this study. Similarly, the study done in Uganda by Muwazi who also worked on a young population which led to low prevalence of periodontitis and later led to reduced statistical power and therefore no association was found 31 .…”

Inflammation Mediators Related to Periodontal Disease and Pregnancy Outcomes: A Call for Quality of Antenatal Care While Promising Evidences Are Emerging

“…Periodontal disease is a chronic inflammatory disease of the soft and hard tissues that support the teeth, caused by bacterial plaque and influenced by host response factors (Zi et al, 2013;Takeuchi et al, 2013;Muwazi et al, 2013). There are two main types of conditions; gingivitis and periodontitis.…”

“…Some of the important clinical features include erythema of the gingiva, edema, hyperplasia, increased bleeding, alterations in the gingival color, tooth mobility, dental migration, pocket depth (Muwazi et al, 2013;Michalowicz et al, 2008). (Michalowicz et al, 2008).…”