Doença periodontal materna e nascimento prematuro: um estudo caso-controle

Abstract

This study was designed to address the association between maternal periodontal disease and preterm birth in a group of Brazilian women. A case-control study with post partum women aged 18-40 yrs was conducted. The mothers included those who gave birth between January and June 2010 at the obstetrics clinic of a general hospital in Juiz de Fora, State of Minas Gerais, Brazil. Demographic and socioeconomic data, information on current and anterior pregnancy histories, and periodontal clinical parameters were collected until 48 hrs after childbirth. Periodontal disease was assessed according to two alternative definitions, namely: definition 1 – four or more teeth with at least one site showing probing depth (PD)≥4 mm and clinical attachment loss (CAL)≥3 mm; and definition 2 – at least one site showing PD and CAL≥4 mm. For each of these definitions, multivariate logistic regression analysis was conducted. Odds ratio (OR) was calculated with a 95% confidence interval (CI), to evaluate the association between periodontal disease and prematurity. A total of 296 post partum women met the inclusion criteria and were divided as followed: 74 women who delivered a preterm neonate were assigned to the case group while the other 222 were assigned to the control group. There were no significant differences neither in demographic information, except for origin municipality, nor in obstetric characteristics. Increased appetite and number of daily toothbrushing were associated with prematurity, regardless the definition of periodontal disease used. Definition 1 of periodontal disease was not associated with fewer weeks of gestation (OR=1.62; CI95%: 0.80-3.29; p=0.178). Significant association was found between definition 2 of periodontal disease and preterm birth (OR=1.98; CI95%: 1.14-3.43; p=0.015). The results suggest that periodontal disease may be an associated risk factor for prematurity, as well as point to the necessity of regular investigation on periodontal condition during pregnancy.