ASSOCIATION OF MATERNAL PERIODONTITIS WITH LOW BIRTH WEIGHT IN NEWBORNS IN A TERTIARY CARE HOSPITAL

Najia Sajjad Khan, Rifat Nisar Ashraf, Shehla Noor, Mahmood -ur- Rahman, Syed Fawad Mashhadi, Zubaida Rashid, Farhana Sajjad, Ali Fawwad Nazar, Hassan Shahzad Nazar, Rabia Syed

Abstract


Background: Low birth weight is a major public health problem in Pakistan. So there is a need for identification of its modifiable risk factors like periodontitis which will reduce its burden on the society. The objectives of the study were to find out the association between maternal periodontitis and low birth weight in newborns of all gestational ages delivered in a tertiary care hospital of Abbottabad as well as to see the frequency of periodontitis severity in these subjects.

Methods: A hospital-based matched case-control study was conducted among 160 postpartum mothers in Gynae B ward Ayub Teaching Hospital, Abbottabad. The 80 cases were mothers of low birth weight babies (<2,500 g), the 80 controls were mothers of normal weight babies (≥2,500 g) matched with maternal age and gestational age. Data was collected through the hospital records, interview and a periodontal examination.

Results: Periodontitis was more in the cases than in the controls (OR: 4.167, 95% CI: 2.142-8.109, p=0.000). On multivariate logistic regression, periodontitis was found to be a significant independent risk factor for low birth weight (aOR: 3.173, 95% CI: 1.429-7.047, p=0.005). Other significant risk factors were educational level (aOR: 3.408, 95% CI: 1.452-7.996, p=0.005), socioeconomic status (aOR: 3.173, 95% CI: 1.366-7.368, p=0.007), maternal nutrition (aOR: 3.071, 95% CI: 1.392-6.778, p=0.005) and moderate/severe anaemia (aOR: 3.035, 95% CI: 1.052-8.756, p=0.040).

Conclusions: Periodontitis is found to be a strong, independent, and clinically significant risk factor for low birth weight. So periodontal therapy should form a part of the antenatal care of the pregnant women in Abbottabad.

Keywords: Low birth weight infant, Periodontitis, Risk Factors.

Background: Low birth weight is a major public health problem in Pakistan. So there is a need for identification of its modifiable risk factors like periodontitis which will reduce its burden on the society. The objectives of the study were to find out the association between maternal periodontitis and low birth weight in new-borns of all gestational ages delivered in a tertiary care hospital of Abbottabad as well as to see the frequency of periodontitis severity in these subjects. Methods: A hospital-based matched case-control study was conducted among 160 postpartum mothers in Gynaecology/Obstetrics-B ward Ayub Teaching Hospital, Abbottabad. The 80 cases were mothers of low birth weight babies (<2,500 g), the 80 controls were mothers of normal weight babies (≥2,500 g) matched with maternal age and gestational age. Data was collected through the hospital records, interview and a periodontal examination. Results: Periodontitis was more in the cases than in the controls (OR: 4.167, 95% CI: 2.142–8.109, p=0.000). On multivariate logistic regression, periodontitis was found to be a significant independent risk factor for low birth weight (aOR: 3.173, 95% CI: 1.429–7.047, p=0.005). Other significant risk factors were educational level (aOR: 3.408, 95% CI: 1.452–7.996, p=0.005), socioeconomic status (aOR: 3.173, 95% CI: 1.366-7.368, p=0.007), maternal nutrition (aOR: 3.071, 95% CI: 1.392-6.778, p=0.005) and moderate/severe anaemia (aOR: 3.035, 95% CI: 1.052–8.756, p=0.040). Conclusions: Periodontitis is found to be a strong, independent, and clinically significant risk factor for low birth weight. So periodontal therapy should form a part of the antenatal care of the pregnant women in Abbottabad.

Keywords: Low birth weight infant, Periodontitis, Risk Factors


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References


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Moliterno LF, Monteiro B, Figueredo CM, Fischer RG. Association between periodontitis and low birth weight: a case-control study. J Clin Periodontol 2005;32(8):886–90.

Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67(10 Suppl):1103–13.

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Usin MM, Menso J, Rodríguez VI, González A, Tabares S, Parodi R, et al. Association between maternal periodontitis and preterm and/or low birth weight infants in normal pregnancies. J Mater Fetal Neonatal Med 2016;29(1):115–9.

Wang YL, Liou JD, Pan WL. Association between maternal periodontal disease and preterm delivery and low birth weight. Taiwan J Obstet Gynecol 2013;52(1):71–6.

Mobeen N, Jehan I, Banday N, Moore J, McClure E, Pasha O, et al. Periodontal disease and adverse birth outcomes: a study from Pakistan. Am J Obstet Gynecol 2008;198(5):514.e1–e8.

Baig SA, Khan N, Baqai T, Fatima A, Karim SA, Aziz S. Preterm birth and its associated risk factors. A study at tertiary care hospitals of Karachi, Pakistan. J Pak Med Assoc 2013;63(3):414–8.

Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. AM Fam physician 2008;77(8):1139–44.

Williams CE, Davenport ES, Sterne JA, Sivapathasundaram V, Fearne JM, Curtis MA. Mechanisms of risk in preterm low‐birthweight infants. Periodontol 2000;23(1):142–50.

Sanz M, Kornman K. Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol 2013;84(4 Suppl):S164–9.

Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes–systematic review. J Clin Periodontol 2013;40(s14):S181–94.


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