Maternal Dental Cleaning before Pregnancy and Birth Outcomes, Georgia PRAMS, 2009-2010

BACKGROUND: Several studies have suggested that maternal oral health has significant implications for birth outcomes. Maternal periodontal disease has been associated with preterm births and delivery of low birth weight infants. Dental cleaning before pregnancy may prevent or retard the progression of periodontal disease thus, leading to better birth outcomes. We assessed the characteristics and birth outcomes of women who had their teeth cleaned during the 12 months before pregnancy.

METHODS: Data were from Georgia’s Pregnancy Risk Assessment and Monitoring System (PRAMS) for 2009-2010. A random sample of new mothers who reside in Georgia is drawn from the birth file and surveyed to collect information on maternal health and behavior before, during and after pregnancy as well as the baby’s health. Univariate, and bivariable analyses were performed to assess dental cleaning before pregnancy and birth outcomes. Analyses were performed with SAS-Callable SUDAAN 11.0.1. The level of significance was set at alpha=0.05.

RESULTS: Less than half of women surveyed (n=2006) had their teeth cleaned within 12 months before their pregnancy (44.5%, 95% CI=41.2%-47.9%). Women 30 years of age and older (54%, 95% CI=48.5%-59.9%) were more likely to have their teeth cleaned before pregnancy than women less than 30 years of age (p=0.0001). Likewise, married women (53%, 95% CI=45.8%-57.6%), white non-Hispanic women (52.2%, 95% CI=47%-57.4%), women with high school degree and above (49.1%, 95% CI=45.2%-52.9%), and women with an annual household income of $50,000 or more (71.7%, 95% CI=65.4%-77.2%) were more likely to have their teeth cleaned before their pregnancy (p<0.0001 respectively). Mothers who drank alcohol 3 months before pregnancy (54%, 95% CI=48.5%-59.4%) were significantly more likely to have their teeth cleaned than mothers who did not drink (38.3%, 95% CI=34.1%-42.7%). There was no significant difference in the prevalence of dental cleaning between mothers who delivered low birth weight babies (42.3%, 95% CI=38.8%-45.8%) and mothers who did not (p=.3402). Likewise, there was no difference in dental cleaning between mothers who delivered preterm babies (41.7%, 95% CI=36.2%–47.3%) and mothers who did not (p=.1958).

CONCLUSIONS:  Factors related to dental cleaning among women before pregnancy included age, race/ethnicity, marital status, education level and household income. However, there was no significant difference in birth outcome between mothers who cleaned their teeth before pregnancy and those who did not. These results may point to the characteristics of women who may need more counseling on the importance of dental cleaning in the pre-conception period.