The association between maternal periodontitis and occurrence of low birth weight babies amongst postnatal women in Kawempe National Referral Hospital

Abstract

Introduction: Despite improvements in maternal nutritional status, antenatal supplementation and better treatment of maternal medical conditions, the rate of low birth weight (LBW) continues to be high. This has prompted the need to identify other modifiable risk factors for LBW. Over the last quarter of a century the possible role of maternal periodontitis in LBW has been investigated and the results have been mixed. It is proposed that inflamed gum tissue in periodontitis acts as a reservoir of bacteria or bacterial products which may translocate into the bloodstream and negatively impact placental function. Objective: To assess the periodontal status of women in the postnatal ward of KNRH and determine if maternal periodontitis increased the odds of low birth weight delivery. Methods: This was a hospital based case-control study with a 1:3 ratio that involved postpartum mothers in the postnatal ward of KNRH. The cases (37 in number) were defined as post-partum mothers who delivered a low birth weight infant, defined by WHO as a new born weighing less than 2500g, after at least 37 weeks of gestation. The controls (111 in number) were defined as postpartum mothers who delivered a normal weight infant after at least 37 weeks of gestation. The participants were assessed for periodontitis using the community periodontal index (CPI) and assigned a score. Multivariate Logistic regression analysis was used to determine if periodontitis was an independent risk factor for low birth weight. Results: The proportion of mothers with periodontitis was higher among the cases compared to the controls (43.3% vs 31.5%, respectively).Periodontitis was associated with a statistically insignificant (p-0.131) increase in the odds of low birth weight with a crude odds ratio of 2.01 (95% CI,0.81-4.98).However, after adjusting for other factors in the multivariate model it was established that periodontitis was not significantly associated with low birth weight; moderate periodontitis(p-0.798) had an adjusted odds ratio (aOR) of 0.82 (95% CI 0.17-3.89) while severe periodontitis (p-0.080) had an aOR of 0.21 (95% CI,0.04-1.20). Conclusion: In this study periodontitis was not an independent risk factor for low birth weight.