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

Abstract

The aim of this study was to assess the association between high gestational weight gain and systemic and periodontal status of women between the 32nd and 36th gestational weeks of pregnancy (T1) and after delivery (T2), and the association of these factors with newborns' health. Methods: The sample was divided into excessive gestational weight gain (GE = 25) and normal gestational weight gain (GN = 25) and was evaluated regarding: (i) socioeconomic status; (ii) systemic and periodontal status; and (iii) newborns' health. The results were analysed using the Mann-Whitney U-test, the t-test, the Friedman test, analysis of variance (ANOVA) and Cochran's Q test (P < 0.05). Results: Women with GE had lower household income (P = 0.010) and higher body mass index (BMI) at both T1 and T2. The prevalence of hypertension at T1 was higher in women with GE, but the condition resolved post-delivery (P = 0.001). Worsening in oral hygiene was observed at T2 in both groups (P < 0.001). Sixty-eight percent of women with GE and 16% of women with GN had periodontitis at T1, and 52% and 12%, respectively, had periodontitis at T2. In women with GE, the BMI of newborns was higher (P = 0.031). Conclusions: Women with high gestational weight gain also showed a high prevalence of hypertension and periodontitis during pregnancy, and persistent periodontitis after delivery. High gestational weight gain was related to high BMI of newborns.

Periodontal status, quality of life and newborns' health of pregnant women with arterial hypertension: A cohort study

“…G1 showed a lower frequency of daily flossing in T1, while G2 showed a significant worsening in daily flossing after delivery (P = 0.004). Both groups showed an increase in the prevalence of visible dental biofilm after delivery (P < 0.001) (Table 1), possibly due to the fact that, after childbirth, the new routine is characterized by a greater time demand for baby care, and there is a negative impact on the quantity and/or quality of oral hygiene (Foratori-Junior, et al, 2020a;Jesuino, et al, 2020). In this study, there were no differences between periods for the prevalence of periodontitis in both groups.…”

“…There is controversy in the literature regarding the association of maternal hypertension, gestational excessive weight, maternal periodontitis, and newborn health. As mentioned, excessive maternal BMI is associated with a high prevalence of arterial hypertension, and studies show a positive association between excessive weight and periodontal impairment during pregnancy (Caracho, et al, 2020;Foratori-Junior, et al, 2020a;Foratori-Junior, et al, 2020b;Foratori-Junior, et al, 2021;Fusco, et al, 2019;Lee, et al, 2014;Jesuino, et al, 2020), and a positive association between obesity and birth of babies with macrosomia (Ijäs, et al, 2019). In contrast, there is scientific evidence that periodontitis during pregnancy is associated with premature rupture of membranes and, consequently, premature birth and child low birth weight (Manrique-Corredor, et al, 2019) due to periodontopathogenic bacteria that, when they fall into the bloodstream, can lodge in the placenta and cause impairment in the availability of nutrients to fetuses and cause a local inflammatory process that results in early contractions.…”

“…For sample size, the Hosmer and Lemeshow protocol for logistic regression analysis was considered, according to previous studies (Caracho, et al, 2020;Foratori-Junior, et al, 2020b). Moreover, according to previous evidences in the same field (Foratori-Junior, et al, 2020a;Foratori-Junior, et al, 2021;Fusco, et al, 2019;Jesuino, et al, 2020) the power test was calculated considering the difference between the mean of CAL of the groups during pregnancy of at least 10%, with a standard deviation of 10%. Based on the mean CAL and standard deviations of the two groups, an effect size of 0.81 was obtained, resulting in a power of 89% with the sample size used.…”

“…Previous studies have pointed out that hypertension in pregnancy is associated with excessive BMI, which in turn, negatively impacts women' periodontal condition because both the high hormonal levels of pregnancy and the inflammatory mediators secreted by the adipose tissue cause exacerbated inflammation in the periodontal tissues (Caracho, et al, 2020;Foratori-Junior, et al, 2020a;Foratori-Junior, et al, 2020b;Foratori-Junior, et al, 2021;Fusco, et al, 2019;Lee, et al, 2014;Jesuino, et al, 2020). In this study, the final logistic regression model revealed that high maternal BMI was associated with the presence of periodontitis during the third trimester of pregnancy (Table 2), pointing out that women with excessive BMI are 28% more likely to develop periodontitis.…”

“…On the other hand, when maternal obesity is associated with periodontitis, infants have been born with low/insufficient weight (Foratori-Junior, et al, 2020b). In addition, although excessive gestational weight gain (GWG) is associated with maternal hypertension, Jesuino et al (2020) showed that pregnant women with excessive GWG had children with body mass index (BMI) at birth above normal (Jesuino, et al, 2020).…”