Factors associated with periodontal disease in pregnant women from Vela Canton, Tungurahua, Ecuador
Keywords:
Periodontal disease, oral health, risk factors, oral hygiene, oral microbiome.Abstract
Introduction: Oral health during pregnancy is essential to prevent maternal and perinatal complications such as low birth weight and premature birth. Periodontal disease, influenced by hormonal factors and inadequate habits, affects a significant proportion of pregnant women, which underlines the need for contextualized research.
Objective: To determine the factors associated with the appearance of periodontal disease in pregnant women from Canton Vela, Tungurahua, Ecuador.
Material and Methods: A descriptive and cross-sectional study was conducted in 62 pregnant women in the second and third trimesters, selected by intentional sampling in a type II health center. Sociodemographic, dietary and oral hygiene habits data were collected. Statistical tests (Chi square and Fisher's exact test) were applied with a significance level of 95% (p < 0.05).
Results: The results show that 77.4% of the participants had periodontal disease. Pregnant women with a higher consumption of sugary drinks (≥3 times/week; OR=8.45; p<0.05) and a lower frequency of brushing (2-3 times/day; OR=3.75; p<0.05) had a higher risk of periodontal disease. Living in rural areas was also a relevant factor (OR=2.34; p<0.05). On the other hand, educational level, monthly income and use of dental floss did not show significant associations.
Conclusions: Periodontal disease is highly prevalent in pregnant women and is associated with inadequate oral hygiene habits and sugar consumption. It is crucial to implement education and prevention programs to reduce these risk factors, especially in rural areas.
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References
1. Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis—A comprehensive review. J Clin Periodontol [Internet]. 2017;44(Suppl. S18):S105. Disponible en: https://doi.org/10.1111/jcpe.12677
2. Starzynska A, Wychowanski P, Nowak M, Sobocki BK, Jereczek BA, Słupecka M. Association between Maternal Periodontitis and Development of Systematic Diseases in Offspring. Int J Mol Sci [Internet]. 2022 [Citado 06/02/2024];23:2473. Disponible en: https://doi.org/10.3390/ijms23052473
3. Dietrich T, Ower P, Tank M, West NX, Walter C, Needleman I, et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions—Implementation in clinical practice. Br Dent J [Internet]. 2019 [Citado 06/02/2024];226:16-22. https://www.nature.com/articles/sj.bdj.2019.3
4. Gil L, Mínguez I, Caffesse R, Llambés F. Periodontal Disease in Pregnancy: The Influence of General Factors and Inflammatory Mediators. Oral Health Prev Den [Internet]. 2019;17(1):69-73. Disponible en: https://doi.org/10.3290/j.ohpd.a41981
5. Jang H, Patoine A, Wu TT, Castillo DA, Xiao J. Oral microflora and pregnancy: A systematic review and meta-analysis. Sci Rep [Internet]. 2021;11:16870. Disponible en: https://doi.org/10.1038/s41598-021-96495-1
6. Zhang Y, Feng W, Li J, Cui L, Chen ZJ. Periodontal Disease and Adverse Neonatal Outcomes: A Systematic Review and Meta-Analysis. Front Pediatr. 2022;10:799740.
7. Cuya R, Chávez A, Flores S, Párraga M, Quinto R, Tafur O. Enfermedad periodontal asociada al embarazo. Rev Cient Odontol (Lima) [Internet]. 2019; 7 (1): 132-139. Disponible en: https://doi.org/10.14212/2523-2754-0701-2019-132-139
8. Gare J, Kanoute A, Meda N, Viennot S, Bourgeois D, Carrouel F. Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review. Int J Environ Res Public Health [Internet]. 2021 [Citado 06/02/2024];18:7194. Disponible en: https://www.mdpi.com/1660-4601/18/13/7194
9. Kumar A. Association between periodontal disease and gestational diabetes mellitus – a prospective cohort study. J Clin Periodontol [Internet]. 2018;45(8):920-931. Disponible en: https://doi.org/10.1111/jcpe.12902
10. Uwambaye P, Munyanshongore C, Rulisa S, Shiau H, Nuhu A, Kerr MS. Assessing the association between periodontitis and premature birth: A case-control study. BMC Pregnancy Childbirth [Internet]. 2021 [Citado 06/02/2024];21:204. https://link.springer.com/article/10.1186/s12884-021-03700-0
11. Figueiredo M, Takita SY, Ramos BM, Sousa H, Olsen E, de Carvalho HR, et al. Periodontal disease: Repercussions in pregnant woman and newborn health-A cohort study. PLoS One [Internet]. 2019;14(11) Nov 22;14(11):e0225036. Disponible en: https://doi.org/10.1371/journal.pone.0225036
12. Massoni RSDS, Aranha AMF, Matos FZ, Guedes OA, Borges H, Miotto M, et al. Correlation of periodontal and microbiological evaluations, with serum levels of estradiol and progesterone, during different trimesters of gestation. Sci Rep [Internet]. 2019;9:11762. Disponible en: https://doi.org/10.1038/s41598-019-48288-w
13. Wen X, Fu X, Zhao C, Yang L, Huang R. The bidirectional relationship between periodontal disease and pregnancy via the interaction of oral microorganisms, hormone and immune response. Front Microbiol [Internet]. 2023 [Citado 06/02/2024];14:1070917. https://pubmed.ncbi.nlm.nih.gov/36778874/
14. Salih Y, Nasr AM, Ahmed ABA, Sharif ME, Adam I. Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan. BMC Res Notes [Internet]. 2020 [Citado 06/02/2024];13(1):147. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066801/
15. Guang W, Emami E, Cheng Z, Santamaria Ch, Qin S. Affiliations ExpandBi WG, et al. Effect of periodontal treatment in pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med [Internet]. 2021;34(19):3259-68. Disponible en: https://doi.org/10.1080/14767058.2019.1678142
16. Sánchez R, Sánchez RJ, Sigcho CR, Expósito Lara A. Factores de riesgo de enfermedad periodontal. CCM [Internet]. 2021 [Citado 06/02/2024];25(1). Disponible en: https://www.medigraphic.com/pdfs/correo/ccm-2021/ccm211p.pdf
17. Erchick DJ, Rai B, Agrawal NK, Khatry SK, Katz J, LeClerq SC, et al. Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal. BMC Oral Health [Internet]. 2019;19(1):2. Disponible en: https://doi.org/10.1186/s12903-018-0681-5
18. Singh S, Nazeer J, Singh R, Kavita K, Iqubal MA, Singh R. Predictors and prevalence of periodontitis among pregnant women of slum areas of Patna, India: an opportunity for oral health promotion. J Educ Health Promot [Internet]. 2021 [Citado 06/02/2024]; 10:133. Disponible en: https://europepmc.org/article/med/34222508
19. Menezes CC, Ribeiro CCC, Alves CMC. Soft drink consumption and periodontal status in pregnant women. J Periodontol [Internet]. 2019 [Citado 06/02/2024]; 90(2):159-66. Disponible en: https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.16-0388
20. Lieske B, Makarova N, Jagemann B, Walther C, Ebinghaus M, Zyriax BC, et al. Inflammatory Response in Oral Biofilm during Pregnancy: A Systematic Review. Nutrients [Internet]. 2022; 14:4894. Disponible en: https://doi.org/10.3390/nu14224894
21. Hess RF, Gilill CS, Demb J. Prevalence and Predictors of Periodontal Disease among Pregnant Women in Mali, West Africa. Ann Med Health Sci Res [Internet]. 2017;7:263–270. Disponible en: https://www.amhsr.org/articles/prevalence-and-predictors-of-periodontal-disease-among-pregnant-women-in-mali-west-africa-3595.html
22. Martinez M, Silvestre-Rangil J, Silvestre FJ. Association between obesity and periodontal disease. A systematic review of epidemiological studies and controlled clinical trials. Med Oral Patol Oral Cir Bucal [Internet]. 2017 [Citado 06/02/2024]; 22-e715. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813989/
23. Abu G, Betsy J, Anil S. Is Obesity a Risk Factor for Periodontal Disease in Adults? A Systematic Review. Int J Environ Res Public Health [Internet]. 2022; 19:12684. Disponible en: https://doi.org/10.3390/ijerph191912684
24. Deghatipour M, Ghorbani Z, Ghanbari S, Arshi S, Ehdayivand F, Namdari M, et al. Oral health status in relation to socioeconomic and behavioral factors among pregnant women: A community-based cross-sectional study. BMC Oral Health [Internet]..2019;19(1):117. Disponible en: https://doi.org/10.1186/s12903-019-0801-x
25. Gare J, Kanoute A, Orsini G, Gonçalves LS, Ali Alshehri F, Bourgeois D, et al. Prevalence, Severity of Extension, and Risk Factors of Gingivitis in a 3-Month Pregnant Population: A Multicenter Cross-Sectional Study. J Clin Med [Internet]. 2023 [Citado 06/02/2024];12:3349. Disponible en: https://doi.org/10.3390/jcm12093349
26. Petersen PE. Global policy for improvement of oral health in the 21st century - implications to oral health research of World Health Assembly 2007, World Health Organization. Community Dent Oral Epidemiol. [Internet]. 2009 [Citado 06/02/2024]; 37:1-8. Disponible en: https://doi.org/10.1111/j.1600-0528.2008.00448.x
27. Bhuyan R, Bhuyan SK, Mohanty JN, Das S, Juliana N, Juliana IF. Periodontitis and Its Inflammatory Changes Linked to Various Systemic Diseases: A Review of Its Underlying Mechanisms. Biomedicines [Internet]. 2022;10(10):2659. Disponible en: https://doi.org/10.3390/biomedicines10102659
28. AMM. Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanos. En: 64ª Asamblea General, Fortaleza, Brasil, octubre 2013 [Internet]. Guatemala: AMM Disponible en: http://www.isciii.es/ISCIII/es/contenidos/fd-investigacion/fd-evaluacion/fd-evaluacion-etica-investigacion/Declaracion-Helsinki-2013-Esp.pdf
29. Contador R, Morales A, Motzfeld R, Treek T, Zapata D. Alfabetización en higiene oral. En su: Manual para el control mecánico del biofilm [Internet]. Santiago: Facultad de Odontología, Universidad de Chile; 2022. Pp.55. Disponible en: https://repositorio.uchile.cl/bitstream/handle/2250/188100/Alfabetizacion-en-higiene-oral.pdf?sequence=3
30. Gil JA, Rivero T, León X, Expósito M, Pérez I. Oral and general health conditions involved in periodontal status during pregnancy: a prospective cohort study. Arch Gynecol Obstet [Internet]. 2023 [Citado 06/02/2024];308:1765-73. Disponible en: https://doi.org/10.1007/s00404-022-06843-3
31. Belay AS, Achimano AA. Prevalence and risk factors for periodontal disease among women attending antenatal care in public hospitals, southwest Ethiopia, 2022: a multicenter cross-sectional study. Clin Cosmet Investig Dent [Internet]. 2022 [Citado 06/02/2024]; 14:153-170. Disponible en: https://www.tandfonline.com/doi/full/10.2147/CCIDE.S367713
32. Wassihun B, Ayinalem A, Beyene K. Knowledge of oral health during pregnancy and associated factors among pregnant mothers attending antenatal care at South Omo Zone public hospitals, Southern Ethiopia, 2021. PLoS One [Internet]. 2022;17(8):e0273795. Disponible en: https://doi.org/10.1371/journal.pone.0273795
33. Pouraskari Z, Hessari H, Yazdani R. Factors affecting oral health of pregnant women: A scoping review. J Dent Med-TUMS [Internet]. 2021;33(4):265-78. Disponible en: https://jdm.tums.ac.ir/article-1-5976-en.pdf
34. Liu P, Wen W, Yu KF, Gao X, Lo ECM, Wong MCM. Effectiveness of a family-centered behavioral and educational counselling approach to improve periodontal health of pregnant women: a randomized controlled trial. BMC Oral Health. [Internet]. 2020 [Citado 06/02/2024];20(1):284. Disponible en: https://doi.org/doi:10.1186/s12903-020-01265-6
35. Britos MR, Sin CS, Ortega SM. Relación entre la Enfermedad periodontal y complicaciones en el Embarazo. Odo Vit [Internet]. 2022 [Citado 23/01/2025];1(36):23-3. Disponible en: https://revistas.ulatina.ac.cr/index.php/odontologiavital/article/view/456
36. Isidro-Olán LB, Estrella-Castillo D, Vega EM, Rueda MA, Rubio HA. Influencia de los determinantes sociales en la salud oral en poblaciones indígenas de las Américas. Revisión de literatura. Odontol Sanmarquina [Internet]. 2022; 25(4): e22888. Disponible en: https://doi.org/10.15381/os.v25i4.22888
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