The Association of Stress and Periodontitis with Low Birth Weight and Preterm Delivery in Danish Pregnant Women: A Cohort Study.

Abstract

Introduction: Pregnancy-related hormonal changes may adversely affect oral health and increase the risk of periodontitis. Periodontitis has been associated with preterm birth (PTB) and low birth weight (LBW). Maternal stress has also been proposed as potential risk factor for adverse birth outcomes, but the combined effect of stress and periodontitis on such outcomes remains unclear. Aim: To investigate the association between periodontitis and (PTB and/or LBW) and whether this association is influenced by perceived stress. Methods: This prospective cohort study included 552 Danish pregnant women. Demographic data were collected via questionnaire. Stress was assessed using the Perceived Stress Scale (PSS-10), and periodontitis was diagnosed clinically by a trained dentist. Both the survey and clinical examinations were conducted between gestational weeks 11 to 20. Logistic regression and interaction tests estimated crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for PTB and LBW. Results: Of the participants, 11% had healthy gums, 56.7% gingivitis, and 32.3% periodontitis. Smoking and lower education were significantly more common among those with periodontitis (p < .001). Neither periodontitis (aOR for PTB = 0.95, CI: 0.28–3.17; LBW = 1.44, CI: 0.29–7.15) nor stress (aOR for high stress and PTB = 0.98, CI: 0.42–2.28; LBW = 1.09, CI: 0.39–3.03) was significantly associated with PTB or LBW. No significant interaction between stress and periodontitis was observed. Conclusion: This study did not find statistically significant associations between maternal periodontitis, perceived stress, or their interaction and PTB or LBW. However, larger studies are needed to confirm these findings and investigate the possible relevance of dental health and stress during pregnancy.