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1.
BMC Oral Health ; 20(1): 284, 2020 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-33066773

RESUMEN

BACKGROUND: Poor oral hygiene and high hormone levels during pregnancy can lead to a deterioration in periodontal health. This study assessed the effectiveness of a family-centered behavioral and educational counselling program on improving the periodontal health of women during pregnancy and postpartum. METHODS: A randomized controlled trial was conducted among pregnant women (10th-22nd gestational week) and their husbands. Participating families were randomized into test and control groups. Intervention in the test group included explanation of oral health education (OHE) pamphlets, oral hygiene instruction, individualized feedback, and proposed solutions to overcome barriers in self-care. Reinforcements were implemented in the 3rd trimester of pregnancy and six months postpartum. In the control group, only OHE pamphlets were distributed. The assessed outcomes were bleeding on probing (BOP), periodontal pocket (Poc), loss of clinical attachment (LoA), and Visible Plaque Index (VPI). The data collection was carried out at baseline (T0), in the 32nd gestational week (T1), and 12 months postpartum (T2). RESULTS: Altogether 589 pregnant women were recruited, and 369 attended all three visits (test:188; control:181). In the test group, the mean VPI score at T0 was 0.19, which decreased to 0.14 at T1 and 0.15 at T2. In the control group, the mean VPI decreased from 0.19 at T0 to 0.16 at T1, but increased to 0.22 at T2. A main effect of time and intervention and an interaction between time and intervention were detected (all p < 0.05), indicating that the intervention effect differed between T1 and T2. The test group showed a significantly greater decrease over time than the control group did. Similarly, the mean BOP% decreased more significantly over time in the test group (T0:57%, T1:46%, T2:35%) than in the control group (T0:58%, T1:52%, T2:46%). For Poc and LoA, there were improvements in both study groups at 12 months postpartum, compared with during pregnancy (p < 0.001). CONCLUSIONS: Providing family-centered, behavioral, and educational counselling to pregnant women at an early stage of pregnancy and with reinforcements can improve their oral hygiene and reduce gingival inflammation. The effect can be sustained over an extended period and is greater than that of distributing oral health leaflets alone. TRIAL REGISTRATION: Clinicaltrials.gov , #NCT02937194. Registered 18 October 2016. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02937194?cond=Family-centered+oral+health+promotion+for+new+parents+and+their+infants&draw=2&rank=1.


Asunto(s)
Higiene Bucal , Mujeres Embarazadas , Consejo , Índice de Placa Dental , Femenino , Humanos , Salud Bucal , Embarazo
2.
J Dent ; 146: 105018, 2024 07.
Artículo en Inglés | MEDLINE | ID: mdl-38679133

RESUMEN

OBJECTIVES: This study aimed to identify the oral microbiota factors contributing to low birth weight (LBW) in Chinese pregnant women and develop a prediction model using machine learning. METHODS: A nested case-control study was conducted in a prospective cohort of 580 Chinese pregnant women, with 23 LBW cases and 23 healthy delivery controls matched for age and smoking habit. Saliva samples were collected at early and late pregnancy, and microbiome profiles were analyzed through 16S rRNA gene sequencing. RESULTS: The relative abundance of Streptococcus was over-represented (median 0.259 vs. 0.116) and Saccharibacteria_TM7 was under-represented (median 0.033 vs. 0.068) in the LBW case group than in controls (p < 0.001, p = 0.015 respectively). Ten species were identified as microbiome biomarkers of LBW by LEfSe analysis, which included 7 species within the genus of Streptococcus or as part of 'nutritionally variant streptococci' (NVS), 2 species of opportunistic pathogen Leptotrichia buccalis and Gemella sanguinis (all LDA score>3.5) as risk biomarkers, and one species of Saccharibacteria TM7 as a beneficial biomarker (LDA= -4.5). The machine-learning model based on these 10 distinguished oral microbiota species could predict LBW, with an accuracy of 82 %, sensitivity of 91 %, and specificity of 73 % (AUC-ROC score 0.89, 95 % CI: 0.75-1.0). Results of α-diversity showed that mothers who delivered LBW infants had less stable salivary microbiota construction throughout pregnancy than the control group (measured by Shannon, p = 0.048; and Pielou's, p = 0.021), however the microbiome diversity did not improve the prediction accuracy of LBW. CONCLUSIONS: A machine-learning oral microbiome model shows promise in predicting low-birth-weight delivery. Even in cases where oral health is not significantly compromised, opportunistic pathogens or rarer taxa associated with adverse pregnancy outcomes can still be identified in the oral cavity. CLINICAL SIGNIFICANCE: This study highlights the potential complexity of the relationship between oral microbiome and pregnancy outcomes, indicating that mechanisms underlying the association between oral microbiota and adverse pregnancy outcomes may involve complex interactions between host factors, microbiota, and systemic conditions. Using machine learning to develop a predictive model based on specific oral microbiota biomarkers provides a potential for personalized medicine approaches. Future prediction models should incorporate clinical metadata to be clinically useful for improving maternal and child health.


Asunto(s)
Recién Nacido de Bajo Peso , Aprendizaje Automático , Microbiota , Boca , ARN Ribosómico 16S , Saliva , Streptococcus , Humanos , Femenino , Embarazo , Estudios de Casos y Controles , Recién Nacido , Adulto , Saliva/microbiología , Boca/microbiología , Estudios Prospectivos , ARN Ribosómico 16S/análisis , Streptococcus/aislamiento & purificación , Biomarcadores/análisis , China , Leptotrichia , Factores de Riesgo
3.
Artículo en Inglés | MEDLINE | ID: mdl-31340485

RESUMEN

BACKGROUND: Pregnant women are at risk of oral health problems. This qualitative study aims to understand dental care-seeking behaviours of pregnant women and their oral health-related information acquisition, to identify barriers to and motivators for, dental visits, and further explore their expectations and possible strategies to improve oral health care during pregnancy. METHODS: Semi-structured interviews were conducted with 30 pregnant women (after 32 gestational weeks) enrolled in the antenatal care programme in a public hospital in Hong Kong. Two main areas of interest were probed: Dental care-seeking behaviour and oral health information acquisition. Their expectations and suggestions on oral health care service for pregnant women were also explored. An inductive thematic approach was adopted to analyse the data. RESULTS: Pregnant women's dental care-seeking behaviour was deterred by some internal factors, such as misunderstandings on oral health, and priority on other issues over oral health. External factors such as inconvenient access to dental service during pregnancy also affected their care-seeking behaviours. Oral health information was passively absorbed by pregnant women through mass media and the social environment, which sometimes led to confusion. Oral health information acquisition from antenatal institutions and care providers was rare. Greater attention was paid to dental visit when they obtained proper information from previous dental visit experience or family members. A potential strategy to improve oral health care suggested by the interviewees is to develop a health care system strengthened by inter-professional (antenatal-dental) collaboration. Efficient oral health information delivery, convenient access to dental service, and improved 'quality' of dental care targeting the needs of pregnant women were identified as possible approaches to improve dental care for this population. CONCLUSION: Dental care-seeking behaviour during pregnancy was altered by various internal and external factors. A lack of, or conflict between, information sources result in confusion that can restrict utilisation of dental service. Integrating dental care into antenatal service would be a viable way to improve dental service utilisation.


Asunto(s)
Atención Odontológica , Conducta en la Búsqueda de Información , Aceptación de la Atención de Salud , Mujeres Embarazadas/psicología , Atención Prenatal , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Hong Kong , Humanos , Salud Bucal , Embarazo , Investigación Cualitativa , Adulto Joven
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