Research Article
Volume 19 Issue 6 - 2020
Maternal Periodontal Disease and Adverse Pregnancy Outcomes at Muhimbili National Hospital, Tanzania: A Cross-Sectional Study
Chermine Nasser*, Bakari S Lembariti and Irene K Minja
Department of Restorative Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar-es- Salaam, Tanzania
*Corresponding Author: Chermine Nasser, Department of Restorative Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar-es- Salaam, Tanzania.
Received: May 11, 2020; Published: May 28, 2020


Background: Periodontal disease (PD) is a multifactorial inflammatory condition in which inappropriate interactions between the host’s immune response and specific groups of bacterial pathogens lead to destruction of connective and bone tissues supporting the teeth. Different studies conducted in developed countries have shown association between maternal periodontitis and adverse pregnancy outcomes such as prematurity and low birth weight infants, however, some other studies have not shown any association.

Aim of the Study: The aim of this study was to determine the relationship between periodontal diseases and birth weight and preterm birth among postpartum women attending postnatal clinic at Muhimbili National Hospital.

Methods: A total of 400 postpartum women, aged 18 to 47 years were recruited for the study. The study involved collection of information on social-demographic characteristics, oral hygiene habits and behavioral factors using a self-administered structured questionnaire. Clinical periodontal examination of Ramfjord Index Teeth for assessment of periodontal status was performed. Chi-square of independence, p value < 0.05 and logistic regression were selected to test for associations.

Results: The mean age of study participants was 28.5 ± 6 years. About 23% of postpartum women were found to have periodontal diseases. The most common clinical (intraoral) findings were plaque (59.5%), followed by gingival bleeding (42.5%) and calculus (35.5%). Periodontal disease was found in 26.9% (n = 45) and 20.2% (n = 47) of mothers with low and normal birthweight babies, respectively. Also, 23.3% (n = 41) and 22.8% (n = 51) of mother with periodontal disease had pre-term and full term babies, respectively.

Conclusion: This study showed that a significant number of post-delivery women suffered from periodontal disease mostly in the form of gingivitis but only a few had periodontitis. The study showed no statistical relationship between periodontal diseases and premature babies and low birth weight babies i.e. p value was not < 0.05. Similarly, no significant association between periodontal diseases and adverse pregnancy outcomes was observed. Regardless, frequent dental check-ups and oral health education should be incorporated in pre and post-natal health education sessions to prevent periodontal diseases.

Keywords: Low Birth Weight; Periodontal Diseases; Postpartum; Preterm; Tanzania


  1. Offenbacher S., et al. “Maternal Periodontitis and Prematurity. Part I: Obstetric Outcome of Prematurity and Growth Restriction”. Annals of Periodontology 1 (2001): 164-174.
  2. Baer PN ML. “Defense mechanism: Textbook of periodontics”. In: Defense mechanism: Textbook of periodontics. Philadelphia: Lippincott (1977): 96-110.
  3. Kassebaum NJ., et al. “Global Burden of Severe Periodontitis in 1990-2010 : A Systematic Review and Meta- regression”. Journal of Dental Research 11 (2014): 1045-1053.
  4. Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF. Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16. Dar es Salaam, Tanzania, and Rockville, Maryland USA (2016): 172-173.
  5. Papapanou PN. “Periodontal Diseases: Epidemiology”. Annals of Periodontology 1 (1996): 1-36.
  6. Adriaens LM., et al. “Does pregnancy have an impact on the subgingival microbiota?” Annals of Periodontology 1 (2009): 72-81.
  7. Madianos PN., et al. “Maternal Periodontitis and Prematurity. Part II: Maternal Infection and Fetal Exposure”. Annals of Periodontology 1 (2001): 175-182.
  8. Boggess KA., et al. “Maternal periodontal disease is associated with an increased risk for preeclampsia”. Obstetrics and Gynecology 2 (2003): 227-231.
  9. Xiong X., et al. “Periodontal disease and adverse pregnancy outcomes : a systematic review”. BJOG: An International Journal of Obstetrics and Gynaecology 113 (2006): 135-143.
  10. Sasieni P., et al. “Risk of preterm birth following surgical treatment for cervical disease : executive summary of a recent symposium”. BJOG: An International Journal of Obstetrics and Gynaecology 123 (2016): 1426-1429.
  11. Turton MS., et al. “A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics”. Biomarkers8 (2017): 740-746.
  12. Vogt M., et al. “Periodontal disease and some adverse perinatal outcomes in a cohort of low risk pregnant women”. Reproductive Health 1 (2010): 29.
  13. Mattheus D., et al. “The Association Between Socio-demographic Factors, Dental Problems, and Preterm Labor for Pregnant Women Residing in Hawai’I”. Hawaii Journal of Medicine and Public Health 8 (2016): 219-227.
  14. Soroye M., et al. “Association between periodontal disease and pregnancy outcomes”. Odonto-Stomatologie Tropicale 152 (2015): 5-16.
  15. Kruse AB., et al. “Association between high risk for preterm birth and changes in gingiva parameters during pregnancy-a prospective cohort study”. Clinical Oral Investigations (2017): 9-10.
  16. Turton M and Africa CWJ. “Further evidence for periodontal disease as a risk indicator for adverse pregnancy outcomes”. International Dental Journal 3 (2017): 148-156.
  17. Scannapieco FA., et al. “Associations Between Periodontal Disease and Risk for Nosocomial Bacterial Pneumonia and Chronic Obstructive Pulmonary Disease. A Systematic Review”. Annals of Periodontology 1 (2003): 54-69.
  18. Offenbacher S., et al. “Effects of Periodontal Therapy on Rate of Preterm Delivery A Randomized Controlled Trial”. Obstetrics and Gynecology 3 (2009): 551-559.
  19. Soucy-Giguère L., et al. “Periodontal Disease and Adverse Pregnancy Outcomes : A Prospective Study in a Low-Risk Population”. Journal of Obstetrics and Gynaecology Canada 4 (2016): 346-350.
  20. Basha S., et al. “Maternal Periodontitis as a Possible Risk Factor for Preterm Birth and Low Birth Weight - A Prospective Study”. Oral Health and Preventive Dentistry 6 (2015): 537-544.
  21. Ide M and Papapanou PN. “Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes - systematic review”. Journal of Periodontology 4 (2013): S181-S194.
  22. Fogacci M., et al. “No association between periodontitis and preterm low birth weight : a case-control study”. Archives of Gynecology and Obstetrics 1 (2018): 71-76.
  23. Santa Cruz I., et al. “Association between periodontal status and pre-term and/or low-birth weight in Spain: Clinical and microbiological parameters”. Journal of Periodontal Research 4 (2013): 443-451.
  24. Amaral C da SF., et al. “The relationship of alcohol dependence and alcohol consumption with periodontitis: A systematic review”. Journal of Dentistry 9 (2009): 643-651.
  25. Yaghini J., et al. “Is periodontal disease related to preeclampsia?” Journal of Dental Research 6 (2012): 770-773.
  26. Mumghamba EGS and Manji KP. “Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: A case-control study”. BMC Oral Health8 (2007): 1-12.
  27. Govindasamy R., et al. “Maternal Risk Factors and Periodontal Disease : A Cross-sectional Study among Postpartum Mothers in Tamil Nadu”. Journal of Pharmacy and Bioallied Sciences 1 (2017): S50-Ss54.
  28. Martínez-martínez R., et al. “Association between periodontitis , periodontopathogens and preterm birth : is it real?” Archives of Gynecology and Obstetrics 1 (2016): 47-54.
  29. Muwazi L., et al. “Periodontal conditions, low birth weight and preterm birth among postpartum mothers in two tertiary health facilities in Uganda”. BMC Oral Health42 (2014): 2-8.
  30. Mathai Metthews and Von Xylander ZJ. “WHO technical consultation on postpartum and postnatal care”. Bulletin of the World Health Organization (2010): 1-56.
  31. Fleiss JL., et al. “Representativeness of the and quot; Ramfjord teeth and quot; for epidemiologic studies of gingivitis and periodontitis”. Community Dentistry and Oral Epidemiology 4 (1987): 221-224.
  32. Petersen PE. “Priorities for research for oral health in the 21st century--the approach of the WHO Global Oral Health Programme”. Community Dental Health 22 (2005): 71-74.
  33. Corbella S., et al. “Adverse pregnancy outcomes and periodontitis: A systematic review and meta-analysis exploring potential association”. Quintessence International 47.3 (2016): 193-204.
  34. Lohana MH., et al. “A Prospective Cohort Study to Assess and Correlate the Maternal Periodontal Status with Their Pregnancy Outcome”. The Journal of Obstetrics and Gynecology of India 1 (2017): 27-32.
  35. Vanterpool SF., et al. “Risk of adverse pregnancy outcomes in women with periodontal disease and the effectiveness of interventions in decreasing this risk: Protocol for systematic overview of systematic reviews”. Systematic Reviews 16 (2016): 1-6.
  36. Desai K., et al. “Significance of maternal periodontal health in preeclampsia”. Journal of International Society of Preventive and Community Dentistry 2 (2015): 103-107.
  37. Teshome A and Yitayeh A. “Relationship between periodontal disease and preterm low birth weight: Systematic review”. The Pan African Medical Journal 24 (2016): 1-10.
  38. Shanbhag S., et al. “The impact of periodontal therapy on oral health related quality of life in adults: A systematic review”. Journal of Clinical Periodontology8 (2012): 725-735.
  39. Tarannum F and Faizuddin M. “Effect of Periodontal Therapy on Pregnancy Outcome in Women Affected by Periodontitis”. Journal of Periodontology 11 (2007): 2095-2103.
  40. Puertas A., et al. “Association of periodontitis with preterm birth and low birth weight: a comprehensive review”. The Journal of Maternal-Fetal and Neonatal Medicine 5 (2017): 1-6.
  41. Ibrahim H., et al. “Oral Health Status , Knowledge , Attitudes and Practice among Pregnant Women attending Omdurman Maternity Hospital , Khartoum , Sudan”. Eastern Mediterranean Health Journal 11 (2017): 802-809.
  42. Rakoto-Alson S., et al. “Periodontal Diseases, Preterm Births, and Low Birth Weight: Findings From a Homogeneous Cohort of Women in Madagascar”. Journal of Clinical Periodontology 2 (2010): 205-213.
  43. Mumghamba EGS., et al. “The usefulness of using Ramfjord teeth in predicting periodontal status of a Tanzanian adult population”. Journal of Clinical Periodontology 1 (2004): 16-18.
Citation: Chermine Nasser., et al. “Maternal Periodontal Disease and Adverse Pregnancy Outcomes at Muhimbili National Hospital, Tanzania: A Cross-Sectional Study”. EC Dental Science 19.6 (2020): 128-137.

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