妊娠期の歯周状態と低体重児出産のリスクに関する観察研究  [in Japanese] Association between Periodontal Status during Pregnancy and Risk of Low Birth Weight: An Observational Study  [in Japanese]

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Author(s)

    • 坂本 治美 SAKAMOTO Harumi
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野|徳島大学病院診療支援部 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School|Medical Technology, Tokushima University Hospital
    • 吉岡 昌美 YOSHIOKA Masami
    • 徳島大学病院歯科衛生室|徳島大学大学院医歯薬学研究部口腔保健福祉学分野 Dental Hygiene Section, Tokushima University Hospital|Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University Graduate School
    • 河野 文昭 KAWANO Fumiaki
    • 徳島大学大学院医歯薬学研究部総合診療歯科学分野 Department of Comprehensive Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School
    • 日野出 大輔 HINODE Daisuke
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野|徳島大学病院歯科衛生室 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School|Dental Hygiene Section, Tokushima University Hospital
    • 十川 悠香 SOGAWA Yuka
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野|徳島大学病院診療支援部|徳島大学病院歯科衛生室 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School|Medical Technology, Tokushima University Hospital|Dental Hygiene Section, Tokushima University Hospital
    • 森山 聡美 MORIYAMA Satomi
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野|徳島大学病院診療支援部 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School|Medical Technology, Tokushima University Hospital
    • 土井 登紀子 DOI Tokiko
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School
    • 中江 弘美 NAKAE Hiromi
    • 徳島大学大学院医歯薬学研究部口腔保健衛生学分野 Department of Hygiene and Oral Health Science, Institute of Biomedical Sciences, Tokushima University Graduate School

Abstract

近年,妊娠期の歯周病予防は周産期の重要な課題とされているが,日本における歯周病と低体重児出産や早産との関連性を示す報告は少ない.本研究の目的は観察研究により妊娠期の歯周状態と低体重児出産との関連性について調査することである.徳島大学病院の妊婦歯科健康診査受診者190名のうち,年齢バイアスの考慮から対象年齢を25~34歳とし,出産時の状況が確認できない者,多胎妊娠および喫煙中の者を除外した85名について,歯周状態と妊娠期の生活習慣や口腔保健に関する知識および低体重児出産との関連性について分析を行った.その結果,口腔内に気になる症状があると答えた者は61名(71.8%),CPI=3(4 mm以上の歯周ポケットを有する)の者は29名(34.1%),CPI=4の者は0名であった.また,対象者をCPI=3の群と,CPI=0, 1, 2の群とに分けて<i>χ</i><sup>2 </sup>検定を行った結果,低体重児出産の項目,およびアンケート調査では,「歯周病に関する知識」,「食べ物の好みの変化」の項目について有意な関連性が認められた.さらに,ロジスティック回帰分析の結果,低体重児出産との有意な関連項目としてCPI=3(OR=6.62,95%CI=1.32–33.36,<i>p</i>=0.02)および口腔内の気になる症状(OR=5.67,95%CI=1.17–27.49,<i>p</i>=0.03)が認められた.以上の結果より,わが国においても,妊婦の歯周状態が低体重児出産のリスクとして関連することが確認できた.本研究結果は,歯科医療従事者による妊婦への歯科保健指導の際の要点として重要であると考えられる.

It has been demonstrated that periodontal disease in pregnant women is associated with adverse pregnancy outcomes; however, there have been few studies examining this relationship in Japan. The aim of this observational study was to investigate the relationship between the periodontal status of pregnant women and a low birth weight. The study included 190 pregnant woman who had been referred to Tokushima University Hospital. Participants received an oral health examination and completed questionnaires about their health behaviors and knowledge of oral health. The inclusion criterion was an age of 25 to 34 years, to avoid age-related bias. Those smoking during pregnancy, with multiple births, or an unknown delivery status were excluded. Among the 85 subjects analyzed, 61 women (71.8%) reported complaints or discomfort related to their oral cavity. A total of 29 women (34.1%) had periodontal pockets (≥4 mm) and were assigned a Community Periodontal Index (CPI) of 3. No pregnant woman was evaluated as CPI=4. We divided participants into two groups: CPI=0,1,2 or CPI=3. A significant difference in qualitative categories was observed among participants with babies with a low birth weight, knowledge about periodontal disease, and those who alternated their favorite foods (chi squared test, <i>p</i><0.05). In addition, we examined the relationship between the oral health status of the pregnant women and a low birth weight. Stepwise logistic regression analysis showed that CPI=3 (OR=6.62, 95% CI: 1.32–33.36; <i>p</i>=0.02) and complaints or discomfort related to the oral cavity (OR=5.67, 95% CI: 1.17–27.49; <i>p</i>=0.03) were significantly correlated with a low birth weight. These results indicate that there is an association between the periodontal status during pregnancy and risk of a low birth weight. These findings should be considered important by dental professionals when giving oral health guidance to pregnant women.

Journal

  • JOURNAL OF DENTAL HEALTH

    JOURNAL OF DENTAL HEALTH 66(3), 322-327, 2016

    Japanese Society for Oral Health

Codes

  • NII Article ID (NAID)
    130005156680
  • NII NACSIS-CAT ID (NCID)
    AN00081407
  • Text Lang
    JPN
  • ISSN
    0023-2831
  • NDL Article ID
    027333481
  • NDL Call No.
    Z19-144
  • Data Source
    NDL  J-STAGE 
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