Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: a hospital-based case control study

Abstract

PurposeLow birth weight (LBW) is one of the major public health problems in India. Hence, there is a need to identify risk factors that, when modified, will reduce the burden of unhealthy children on the healthcare system. The objective of this study was to determine whether periodontitis among mothers in the rural population of India is a risk factor for LBW babies.MethodsA hospital-based case control study was conducted among 340 postpartum mothers. The cases consisted of 170 women who had given birth to babies weighing <2,500 g, while the control group consisted of 170 women who had given birth to babies weighing ≥2,500 g. Details of the mothers were taken from the hospital records and through a personal interview, and a full-mouth periodontal examination was performed postpartum, which included probing depth, clinical attachment level, and bleeding on probing on six sites per tooth.ResultsLBW cases had a significantly worse periodontal status than the controls, having an odds ratio (OR) of 2.94 (P=0.01). The multivariate logistic regression model demonstrated that periodontal disease is a significant independent risk factor with an adjusted odds ratio (aOR) of 2.85 for the LBW group (95% confidence interval [CI], 1.62-5.5). Other factors showing significant associations with LBW were pre-eclampsia (aOR, 4.49; 95% CI, 1.4-14.7), preterm labor (aOR, 5.5; 95% CI, 3.2-9.9), and vaginal type of delivery (aOR, 2.74; 95% CI, 1.4-5.2).ConclusionsPeriodontitis represents a strong, independent, and clinically significant risk factor for LBW. Periodontal therapy should form a part of the antenatal preventive care among rural women in India.Graphical Abstract

Increased infection with key periodontal pathogens during gestational diabetes mellitus

“…Increased gingival inflammation is well documented during pregnancy (Ehlers et al 2013, Figuero et al 2013, Niederman 2013 while periodontal diseases increase risk for maternal (hypertension and preeclampsia) and fetal complications (low birth weight and pre-term birth) (Marin et al 2005, Guimaraes et al 2012, Pralhad et al 2013, Ha et al 2014, Jacob & Nath 2014, Rao et al 2014. For example, active periodontal inflammation, as determined by bleeding on probing, has been reported to correlate with reductions in fetal femur length, birth weight and birth length ).…”

Preterm Birth Prevention: How Well Are We Really Doing? A Review of the Latest Literature

“…A recent case control study among rural women in India [26] found that mothers to LBW babies had significantly worse periodontal status. Periodontal disease demonstrated an adjusted OR of 2.85 for low birth rate and was suggested to be addressed as part of the antenatal preventive care among rural women in India.…”

Link between Periodontal Disease and Coronary Artery Disease: Bangladesh Perspective

“…54 The Link between PD and CAD Periodontitis has been found to be associated with a number of systemic diseases and conditions, including stroke, 55 peripheral arterial disease, 56 type 2 diabetes, 57 rheumatoid arthritis, 58 chronic kidney disease, 59 and chronic obstructive pulmonary disease, 60 Alzheimer's disease, 61 cancers, 62 anaemia, 63 and low-birth weight baby. [64][65] Currently, however, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. 66 The relationship between PD and CAD is predominantly epidemiological based on crosssectional and longitudinal studies, and their meta-analysis.…”