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Published in: BMC Oral Health 1/2014

Open Access 01-12-2014 | Research article

Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda

Authors: Louis Muwazi, Charles Mugisha Rwenyonyi, Moses Nkamba, Annet Kutesa, Mike Kagawa, Godfrey Mugyenyi, Godfrey Kwizera, Isaac Okullo

Published in: BMC Oral Health | Issue 1/2014

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Abstract

Background

Literature reports have indicated an increase in research evidence suggesting association between periodontal disease and the risk of pre-term birth (PTB) and low birth weight (LBW). Periodontal diseases in Uganda have been documented as a public health problem, but their association to adverse pregnancy outcomes is unknown. This study was conducted to assess the association between periodontital diseases in postpartum mothers and PTB and LBW of babies in Mulago and Mbarara referral hospitals.

Methods

This was a cross sectional study using medical records, clinical examination and oral interview of mothers at the two tertiary health facilities. Mothers with singleton babies from Mulago (n = 300) and Mbarara Hospital (n = 100) were recruited for the study. The women were clinically examined for periodontal disease by 2 trained and calibrated dentists. Data on PTB and LBW were retrieved from medical records. The data were analyzed to determine the relationship between the four parameters for periodontal disease (bleeding gingiva, periodontal pockets, gingival recession and calculus with plaque deposits) and the adverse pregnancy outcomes. Frequency distribution was used to describe the data. Bivariate and multivariate analyses were used to study the association between the periodontal diseases and adverse pregnancy outcomes.

Results

Approximately 26% and 29% of the postpartum mothers examined had bleeding gingiva and periodontal pockets of 4 mm or more deep, respectively. Advanced periodontitis i.e. pocket depth ≥ 6 mm was recorded in 13 (3.6%) of the mothers. Calculus with plaque deposits were recorded in 86% (n = 343) of the mothers. Gingival recession was recorded in 9.0% of the mothers and significantly and directly related to birth weight (p < 0.05).

Conclusion

Periodontal conditions of postpartum mothers in this study were found to be better than previously reported amongst the Ugandan population. Bivariate analysis showed a significant association only between gingival recession and low birth weight. However, this finding should be interpreted with caution as it could have occurred by chance.
Literature
1.
go back to reference Lamster IB, Smith QT, Celenti RS, Singer RE, Grbic JT: Development of a risk profile for periodontal disease: microbial and host response factors. J Periodontol. 1994, 65 (5 Suppl): 511-520.CrossRefPubMed Lamster IB, Smith QT, Celenti RS, Singer RE, Grbic JT: Development of a risk profile for periodontal disease: microbial and host response factors. J Periodontol. 1994, 65 (5 Suppl): 511-520.CrossRefPubMed
2.
go back to reference Pihlstrom BL, Michalowicz BS, Johnson NW: Periodontal diseases. Lancet. 2005, 366 (9499): 1809-1820. 10.1016/S0140-6736(05)67728-8.CrossRefPubMed Pihlstrom BL, Michalowicz BS, Johnson NW: Periodontal diseases. Lancet. 2005, 366 (9499): 1809-1820. 10.1016/S0140-6736(05)67728-8.CrossRefPubMed
3.
go back to reference Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J: Treatment of periodontitis and endothelial function. N Engl J Med. 2007, 356 (9): 911-920. 10.1056/NEJMoa063186.CrossRefPubMed Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J: Treatment of periodontitis and endothelial function. N Engl J Med. 2007, 356 (9): 911-920. 10.1056/NEJMoa063186.CrossRefPubMed
4.
go back to reference Ramfjord SP, Ash MM: [Periodontology and periodontics: modern theory and practice]. IshiyakuEuroAmerica, Inc. 1989, 28 (12): 949-968. Ramfjord SP, Ash MM: [Periodontology and periodontics: modern theory and practice]. IshiyakuEuroAmerica, Inc. 1989, 28 (12): 949-968.
5.
go back to reference Kramer MS: The epidemiology of adverse pregnancy outcomes: an overview. J Nutr. 2003, 133 (5 Suppl 2): 1592S-1596S.PubMed Kramer MS: The epidemiology of adverse pregnancy outcomes: an overview. J Nutr. 2003, 133 (5 Suppl 2): 1592S-1596S.PubMed
6.
go back to reference Namiiro FB, Mugalu J, McAdams RM: Poor birth rate recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda. BMC Pregnancy Childbirth. 2012, 9(12):1. doi: 10.1186/1471-2393-12-1 Namiiro FB, Mugalu J, McAdams RM: Poor birth rate recovery among low birth weight/preterm infants following hospital discharge in Kampala, Uganda. BMC Pregnancy Childbirth. 2012, 9(12):1. doi: 10.1186/1471-2393-12-1
7.
go back to reference Lawn JE, Davidge R, Vinod P, von Xylander S, de Graft Johnson J, Costello A, Kinney M, Segre J, Molyneux L, Born Too Soon: Care for the preterm baby. Reproductive Health. 2013, 10(Suppl 1):S5. doi:10.1186/1742-4755-10-S1-S5 Lawn JE, Davidge R, Vinod P, von Xylander S, de Graft Johnson J, Costello A, Kinney M, Segre J, Molyneux L, Born Too Soon: Care for the preterm baby. Reproductive Health. 2013, 10(Suppl 1):S5. doi:10.1186/1742-4755-10-S1-S5
9.
go back to reference Villar J, Belizan JM: The relative contribution of prematurity and fetal growth retardation to low birth weight in developing and developed societies. Am J Obstet Gynecol. 1982, 143 (7): 793-798.CrossRefPubMed Villar J, Belizan JM: The relative contribution of prematurity and fetal growth retardation to low birth weight in developing and developed societies. Am J Obstet Gynecol. 1982, 143 (7): 793-798.CrossRefPubMed
10.
go back to reference Gibbs RS, Romero R, Hillier SL, Eschenbach DA, Sweet RL: A review of premature birth and subclinical infection. Am J Obstet Gynecol. 1992, 166 (5): 1515-1528. 10.1016/0002-9378(92)91628-N.CrossRefPubMed Gibbs RS, Romero R, Hillier SL, Eschenbach DA, Sweet RL: A review of premature birth and subclinical infection. Am J Obstet Gynecol. 1992, 166 (5): 1515-1528. 10.1016/0002-9378(92)91628-N.CrossRefPubMed
11.
go back to reference Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW, Rich-Edwards JW: Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol. 2008, 36 (1): 3-11.PubMed Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW, Rich-Edwards JW: Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol. 2008, 36 (1): 3-11.PubMed
12.
go back to reference Scannapieco FA, Bush RB, Paju S: Periodontal disease as a risk factor for adverse pregnancy outcomes. A systematic review. Ann Periodontol. 2003, 8 (1): 70-78. 10.1902/annals.2003.8.1.70.CrossRefPubMed Scannapieco FA, Bush RB, Paju S: Periodontal disease as a risk factor for adverse pregnancy outcomes. A systematic review. Ann Periodontol. 2003, 8 (1): 70-78. 10.1902/annals.2003.8.1.70.CrossRefPubMed
13.
go back to reference Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S: Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG. 2006, 113 (2): 135-143. 10.1111/j.1471-0528.2005.00827.x.CrossRefPubMed Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S: Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG. 2006, 113 (2): 135-143. 10.1111/j.1471-0528.2005.00827.x.CrossRefPubMed
14.
go back to reference Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J: Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996, 67 (10 Suppl): 1103-1113.CrossRefPubMed Offenbacher S, Katz V, Fertik G, Collins J, Boyd D, Maynor G, McKaig R, Beck J: Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. 1996, 67 (10 Suppl): 1103-1113.CrossRefPubMed
15.
go back to reference McGaw T: Periodontal disease and preterm delivery of low-birth-weight infants. J Can Dent Assoc. 2002, 68 (3): 165-169.PubMed McGaw T: Periodontal disease and preterm delivery of low-birth-weight infants. J Can Dent Assoc. 2002, 68 (3): 165-169.PubMed
16.
go back to reference Khader YS, Ta’ani Q: Periodontal diseases and the risk of preterm birth and low birth weight: a meta-analysis. J Periodontol. 2005, 76 (2): 161-165. 10.1902/jop.2005.76.2.161.CrossRefPubMed Khader YS, Ta’ani Q: Periodontal diseases and the risk of preterm birth and low birth weight: a meta-analysis. J Periodontol. 2005, 76 (2): 161-165. 10.1902/jop.2005.76.2.161.CrossRefPubMed
17.
go back to reference Lopez NJ, Da Silva I, Ipinza J, Gutierrez J: Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol. 2005, 76 (11 Suppl): 2144-2153.CrossRefPubMed Lopez NJ, Da Silva I, Ipinza J, Gutierrez J: Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol. 2005, 76 (11 Suppl): 2144-2153.CrossRefPubMed
18.
go back to reference Lopez NJ, Smith PC, Gutierrez J: Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol. 2002, 73 (8): 911-924. 10.1902/jop.2002.73.8.911.CrossRefPubMed Lopez NJ, Smith PC, Gutierrez J: Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease: a randomized controlled trial. J Periodontol. 2002, 73 (8): 911-924. 10.1902/jop.2002.73.8.911.CrossRefPubMed
19.
go back to reference Paquette DW: Periodontal disease and the Risk for adverse Pregnancy Outcomes. Grand Rounds in Oral Sys Med. 2006, 4:14-24 Paquette DW: Periodontal disease and the Risk for adverse Pregnancy Outcomes. Grand Rounds in Oral Sys Med. 2006, 4:14-24
20.
go back to reference Chaim W, Mazor M: Intraamniotic infection with fusobacteria. Arch Gynecol Obstet. 1992, 251 (1): 1-7. 10.1007/BF02718272.CrossRefPubMed Chaim W, Mazor M: Intraamniotic infection with fusobacteria. Arch Gynecol Obstet. 1992, 251 (1): 1-7. 10.1007/BF02718272.CrossRefPubMed
21.
go back to reference Altshuler G, Hyde S: Fusobacteria. An important cause of chorioamnionitis. Arch Pathol Lab Med. 1985, 109 (8): 739-743.PubMed Altshuler G, Hyde S: Fusobacteria. An important cause of chorioamnionitis. Arch Pathol Lab Med. 1985, 109 (8): 739-743.PubMed
22.
go back to reference Bearfield C, Davenport ES, Sivapathasundaram V, Allaker RP: Possible association between amniotic fluid micro-organism infection and microflora in the mouth. Br J Obstet Gynaecol. 2002, 109: 527-533. 10.1111/j.1471-0528.2002.01349.x.CrossRef Bearfield C, Davenport ES, Sivapathasundaram V, Allaker RP: Possible association between amniotic fluid micro-organism infection and microflora in the mouth. Br J Obstet Gynaecol. 2002, 109: 527-533. 10.1111/j.1471-0528.2002.01349.x.CrossRef
23.
go back to reference Carroll GC, Sebor RJ: Dental flossing and its relationship to transient bacteremia. J Periodontol. 1980, 51 (12): 691-692. 10.1902/jop.1980.51.12.691.CrossRefPubMed Carroll GC, Sebor RJ: Dental flossing and its relationship to transient bacteremia. J Periodontol. 1980, 51 (12): 691-692. 10.1902/jop.1980.51.12.691.CrossRefPubMed
24.
go back to reference Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS: Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth. Infect Immun. 2004, 72 (4): 2272-2279. 10.1128/IAI.72.4.2272-2279.2004.CrossRefPubMedPubMedCentral Han YW, Redline RW, Li M, Yin L, Hill GB, McCormick TS: Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth. Infect Immun. 2004, 72 (4): 2272-2279. 10.1128/IAI.72.4.2272-2279.2004.CrossRefPubMedPubMedCentral
25.
go back to reference Jiang H, Xiong X, Su Y, Zhang Y, Wu H, Jiang Z, Qian X: A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes. BMC Pregnancy Childbirth. 2013, 13: 228-10.1186/1471-2393-13-228.CrossRefPubMedPubMedCentral Jiang H, Xiong X, Su Y, Zhang Y, Wu H, Jiang Z, Qian X: A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes. BMC Pregnancy Childbirth. 2013, 13: 228-10.1186/1471-2393-13-228.CrossRefPubMedPubMedCentral
26.
go back to reference Tiromwe F, Ekoku Y, Manji F, Baelum V, Fejerskov O: Oral health in Uganda, Result of National Survey 1987. 1988, Ministry of Health Uganda/Kenya Medical Research Institute Tiromwe F, Ekoku Y, Manji F, Baelum V, Fejerskov O: Oral health in Uganda, Result of National Survey 1987. 1988, Ministry of Health Uganda/Kenya Medical Research Institute
27.
go back to reference World Health Organization: Oral health surveys. Basic methods 4th ed. Geneva. 1997 World Health Organization: Oral health surveys. Basic methods 4th ed. Geneva. 1997
28.
go back to reference Borrell LN, Papapanou PN: Analytical epidemiology of periodontitis. J Clin Periodontol. 2005, 32 (Suppl 6): 132-158.CrossRefPubMed Borrell LN, Papapanou PN: Analytical epidemiology of periodontitis. J Clin Periodontol. 2005, 32 (Suppl 6): 132-158.CrossRefPubMed
29.
go back to reference Krleža-Jerić K, Lemmens T: 7th Revision of the Declaration of Helsinki: Good News for the Transparency of Clinical Trials. Croat Med J. Apr. 2009, 50(2):105–110 Krleža-Jerić K, Lemmens T: 7th Revision of the Declaration of Helsinki: Good News for the Transparency of Clinical Trials. Croat Med J. Apr. 2009, 50(2):105–110
30.
go back to reference Agueda A, Ramon JM, Manau C, Guerrero A, Echeverria JJ: Periodontal disease as a risk factor for adverse pregnancy outcomes: a prospective cohort study. J Clin Periodontol. 2008, 35 (1): 16-22.PubMed Agueda A, Ramon JM, Manau C, Guerrero A, Echeverria JJ: Periodontal disease as a risk factor for adverse pregnancy outcomes: a prospective cohort study. J Clin Periodontol. 2008, 35 (1): 16-22.PubMed
31.
go back to reference Portney LG, Watkins MP: Foundations of clinical research Applications to practice. 2000, New Jersey: Prentice Hall Inc, 560-567. Portney LG, Watkins MP: Foundations of clinical research Applications to practice. 2000, New Jersey: Prentice Hall Inc, 560-567.
32.
go back to reference Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE, Norderyd OM, Genco RJ: Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol. 1994, 65 (3): 260-267. 10.1902/jop.1994.65.3.260.CrossRefPubMed Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE, Norderyd OM, Genco RJ: Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol. 1994, 65 (3): 260-267. 10.1902/jop.1994.65.3.260.CrossRefPubMed
33.
go back to reference Daly CG, Mitchell DH, Highfield JE, Grossberg DE, Stewart D: Bacteremia due to periodontal probing: a clinical and microbiological investigation. J Periodontol. 2001, 72 (2): 210-214. 10.1902/jop.2001.72.2.210.CrossRefPubMed Daly CG, Mitchell DH, Highfield JE, Grossberg DE, Stewart D: Bacteremia due to periodontal probing: a clinical and microbiological investigation. J Periodontol. 2001, 72 (2): 210-214. 10.1902/jop.2001.72.2.210.CrossRefPubMed
Metadata
Title
Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda
Authors
Louis Muwazi
Charles Mugisha Rwenyonyi
Moses Nkamba
Annet Kutesa
Mike Kagawa
Godfrey Mugyenyi
Godfrey Kwizera
Isaac Okullo
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2014
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-14-42

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