The Impact of Maternal Oral Health Practices during Pregnancy on Birth Outcome: Preliminary Findings from Pregnancy Risk Assessment Monitoring System (PRAMS) Data Analysis

Author ORCiD

0000-0002-1637-407X

Department

Joint School of Public Health

Graduate Level

Doctoral

Graduate Program/Concentration

Health Services Research, Ph.D.

Presentation Type

Poster Presentation

Abstract

Background: Preterm birth (PTB) (delivery prior to 37 weeks of pregnancy) and low birth weight (LBW) (weighing less than 2500 grams at birth) present a major public health challenge. Both conditions lead to neonatal morbidity, mortality, and long-term complications, placing economic and emotional burdens on families and healthcare systems. There is strong biological plausibility that high periodontal bacterial loads from periodontal disease (PD) in pregnant women may increase the risk of PTB and LBW through bacterial transmission and inflammatory pathways affecting the placenta. This study aims to analyze the association between maternal oral health-related experiences during pregnancy and PTB/LBW using 10-year data from PRAMS Virginia.

Methods: This study is a secondary data analysis of Virginia PRAMS Phases 7 and 8, representing women surveyed within the state between 2012 and 2022. PRAMS is a state-based surveillance system in which women are selected after delivery from the birth certificates to provide a representative sample. Univariable logistic regression models were used to calculate crude odds ratios (COR) and their 95% confidence intervals (CIs) to examine associations between maternal oral health-related experiences, such as dental cleaning and dental insurance coverage, and PTB/LBW. The complex structure of PRAMS, including stratification and weighting, was taken into account during this analysis. All statistical analyses were conducted using SAS, with significance set at P < 0.05.

Results: This analysis included 8,820 women who gave live birth in Virginia from 2012-2022. The prevalence of PTB and LBW was 9.07% and 7.13%, respectively. In univariable analysis, the receipt of dental cleaning during pregnancy was associated with lower odds of PTB (COR=0.80, 95% CI: 0.64–0.99, p=0.037) and LBW (COR=0.79, 95% CI: 0.65–0.96, p=0.016). Similarly, having dental insurance decreased the odds of PTB (COR=0.75, 95% CI: 0.59–0.95, p=0.018) and LBW (COR=0.80, 95% CI: 0.64–0.98, p=0.035).

Conclusion: Preliminary findings suggest that the receipt of dental cleaning and having dental insurance during pregnancy may decrease the risk of PTB and LBW. These results highlight the importance of integrating oral health services into prenatal care and expanding access to affordable dental care to improve maternal and infant health outcomes. Further analysis of these data will deal with measured and unmeasured confounding through complex statistical approaches.

Keywords

Pregnancy, Low birth weight, Preterm birth, Periodontal disease, periodontal treatment

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The Impact of Maternal Oral Health Practices during Pregnancy on Birth Outcome: Preliminary Findings from Pregnancy Risk Assessment Monitoring System (PRAMS) Data Analysis

Background: Preterm birth (PTB) (delivery prior to 37 weeks of pregnancy) and low birth weight (LBW) (weighing less than 2500 grams at birth) present a major public health challenge. Both conditions lead to neonatal morbidity, mortality, and long-term complications, placing economic and emotional burdens on families and healthcare systems. There is strong biological plausibility that high periodontal bacterial loads from periodontal disease (PD) in pregnant women may increase the risk of PTB and LBW through bacterial transmission and inflammatory pathways affecting the placenta. This study aims to analyze the association between maternal oral health-related experiences during pregnancy and PTB/LBW using 10-year data from PRAMS Virginia.

Methods: This study is a secondary data analysis of Virginia PRAMS Phases 7 and 8, representing women surveyed within the state between 2012 and 2022. PRAMS is a state-based surveillance system in which women are selected after delivery from the birth certificates to provide a representative sample. Univariable logistic regression models were used to calculate crude odds ratios (COR) and their 95% confidence intervals (CIs) to examine associations between maternal oral health-related experiences, such as dental cleaning and dental insurance coverage, and PTB/LBW. The complex structure of PRAMS, including stratification and weighting, was taken into account during this analysis. All statistical analyses were conducted using SAS, with significance set at P < 0.05.

Results: This analysis included 8,820 women who gave live birth in Virginia from 2012-2022. The prevalence of PTB and LBW was 9.07% and 7.13%, respectively. In univariable analysis, the receipt of dental cleaning during pregnancy was associated with lower odds of PTB (COR=0.80, 95% CI: 0.64–0.99, p=0.037) and LBW (COR=0.79, 95% CI: 0.65–0.96, p=0.016). Similarly, having dental insurance decreased the odds of PTB (COR=0.75, 95% CI: 0.59–0.95, p=0.018) and LBW (COR=0.80, 95% CI: 0.64–0.98, p=0.035).

Conclusion: Preliminary findings suggest that the receipt of dental cleaning and having dental insurance during pregnancy may decrease the risk of PTB and LBW. These results highlight the importance of integrating oral health services into prenatal care and expanding access to affordable dental care to improve maternal and infant health outcomes. Further analysis of these data will deal with measured and unmeasured confounding through complex statistical approaches.