Association Between Maternal Periodontitis and Adverse Pregnancy Outcomes: A Cross-Sectional Study at a Maternity Hospital in Kathmandu, Nepal

母体牙周炎与不良妊娠结局之间的关联:尼泊尔加德满都一家妇产医院的横断面研究

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Abstract

BACKGROUND: Adverse pregnancy outcomes, including preterm birth and low birth weight, are major global health challenges, leading to millions of newborn deaths each year. Since 1996, periodontitis and related gum diseases have been proposed as potential contributing factors, but research findings remain mixed. Further research is needed to clarify this link. OBJECTIVE: This study aims to assess the status of periodontitis and its association with adverse pregnancy outcomes. METHODOLOGY: A cross-sectional study was conducted among 145 third-trimester mothers attending antenatal care (ANC) checkups at Maternity Hospital in Kathmandu. Data were gathered from medical records, interviews, and oral health screenings using the Community Periodontal Index (CPI) for periodontitis. Birth outcomes were assessed after delivery through medical records, which are considered highly reliable, with established protocols for data entry, consistent documentation, and regular quality control measures ensuring accuracy and consistency across healthcare providers. Ethical approval was obtained from the Nepal Health Research Council (NHRC) (approval no. 423) on September 19, 2023. RESULTS: Periodontitis was observed in 53 (36.6%) participants, with a higher prevalence in individuals aged 30 or more (10, 43.5%) and those who were illiterate (4, 50%). Health conditions such as hypertension, diabetes, and urinary tract infections were associated with higher periodontitis rates. However, no significant associations were found between age, education, obstetric history, or health conditions and adverse pregnancy outcomes. Periodontitis showed a significant association with adverse outcomes, with 56.6% of those with periodontitis experiencing adverse outcomes, compared to 32.6% without periodontitis (P = 0.005). The odds ratio of 2.69 indicates individuals with periodontitis are 2.69 times more likely to experience adverse outcomes. CONCLUSIONS: Maternal periodontitis is significantly associated with adverse pregnancy outcomes, with individuals having periodontitis being 2.69 times more likely to experience such outcomes. These findings highlight the importance of incorporating periodontal care into prenatal healthcare.

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