Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system

Abstract

Objective This observational cross‐sectional study aimed to evaluate systemic and oral conditions in pregnant women with excessive pre‐pregnancy weight (PEW) and normal pre‐pregnancy weight (PNW) who underwent follow‐up in the private healthcare system during the third trimester of pregnancy. Methods Fifty pregnant women were evaluated from August 2017 to February 2018 and divided into two groups: women with PEW (n = 25); and those with PNW (n = 25). Their weight and body mass index (BMI), periodontal disease status, stimulated salivary flow, and systemic condition were evaluated. Statistical analyses were conducted using t‐test, Mann–Whitney test, chi‐square test and binary logistic regression (P < 0.05). Results The groups did not differ in age, educational level or monthly household income (P > 0.05). The PEW group had a higher frequency of arterial hypertension (P = 0.019) and excessive weight gain during gestation (P = 0.010), sought dental services less frequently, and had increased severity of periodontitis (P < 0.0001). Both groups presented low salivary flow, with no intergroup difference. In the final binary logistic regression models, high maternal pre‐pregnancy BMI was a significant predictor of arterial hypertension and periodontitis during the third trimester of gestation; maternal excessive weight gain was also a significant predictor of periodontitis during pregnancy. Conclusion Women with PEW who underwent follow‐up in a private healthcare system had a higher prevalence of arterial hypertension and worse periodontal status during the third trimester of pregnancy as compared to women with normal weight.

Periodontal status of women with excessive gestational weight gain and the association with their newborns’ health

“…In our study, patients with excessive GWG had a lower monthly income ( Figure ) and higher BMI at all study assessment periods, including after childbirth ( Figure ). This is in agreement with the findings of previous studies that inadequate dietary pattern, characterised by the consumption of low‐cost food that is more caloric and less nutritious, is an important contributing factor to the association between high BMI and excessive GWG 16,33 .…”

“…Explanations for the high prevalence of hypertension found in women with excessive GWG has been described in detail elsewhere 26,33 . Hypertension is associated with vascular inflammation and endothelial disturbance 33,41,42 .…”

“…Explanations for the high prevalence of hypertension found in women with excessive GWG has been described in detail elsewhere 26,33 . Hypertension is associated with vascular inflammation and endothelial disturbance 33,41,42 . Therefore, the process of vascular inflammation is related to the release of inflammatory mediators that increase vascular permeability and promote cytoskeletal changes to the endothelial cells.…”

“…Therefore, the process of vascular inflammation is related to the release of inflammatory mediators that increase vascular permeability and promote cytoskeletal changes to the endothelial cells. Consequently, endothelial dysfunction causes an imbalance between vasodilation and vasoconstriction, thereby increasing blood pressure, which is clinically observed as hypertension 33,41,42 .…”

“…Previous findings have indicated an association between excessive weight and periodontal impairments during pregnancy 16,26,33,45,49–53 . Nonetheless, no study has focussed on specifically evaluating systemic and periodontal conditions in pregnant women with excessive GWG.…”