中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (4): 431-435.DOI: 10.19538/j.kq.2024.04.009

• 论著 • 上一篇    下一篇

孕妇牙周状况和口腔幽门螺杆菌感染情况及其影响因素研究

  

  1. 1. 川北医学院口腔医学院，四川 南充 637000；2. 川北医学院附属医院口腔科，四川 南充 637000
  • 出版日期:2024-07-30 发布日期:2024-07-30
  • 通讯作者: 朱万春
  • 基金资助:
    2020年川北医学院附属医院科研发展计划项目（2021ZD012）；中华口腔医学会西部口腔医学临床科研基金项目（CSA-W2020-09）；南充市市校战略合作科技项（19SXHZ0077）

  • Online:2024-07-30 Published:2024-07-30

摘要： 目的    研究孕妇牙周状况和口腔幽门螺杆菌（Helicobacter pylori，Hp）感染情况及其影响因素。方法    选择2023年1—10月于川北医学院附属医院定期产检的190名孕妇作为研究对象。采用自行设计问卷对所有孕妇行口腔卫生行为调查；采用视诊和探诊结合的方法，对孕妇行口腔检查，记录牙结石、探诊出血、牙周附着水平、探诊深度等牙周指标；采用Hp检测纸（干化学法）检测孕妇口腔Hp感染情况；记录不良妊娠结局（早产和低出生体重儿）发生情况。结果    孕妇牙周炎患病率为49.5%（94/190），口腔Hp感染率为44.7%（85/190）。1年内洁牙（OR = 0.238，95%CI：0.108 ~ 0.527，P < 0.001）、牙结石（OR = 2.150，95%CI：1.125 ~ 4.109，P = 0.021）是患牙周炎的独立影响因素；每次刷牙时长> 3 min（OR = 0.268，95%CI：0.104 ~ 0.691，P = 0.006）、有妊娠期呕吐（OR = 2.165，95%CI：1.147 ~ 4.088，P = 0.017）、患牙周炎（OR = 2.086，95%CI：1.101 ~ 3.954，P = 0.024）是口腔Hp感染的独立影响因素。190名孕妇中10名发生早产、6名发生低出生体重儿，不良妊娠结局发生率为8.42%。患牙周炎及口腔Hp感染组、仅患牙周炎组、仅口腔Hp感染组、无牙周炎及无口腔Hp感染组不良妊娠结局发生率依次为18.00%（9/50）、6.82%（3/44）、8.57%（3/35）、1.64%（1/61），其差异有统计学意义（P = 0.019）。结论    孕妇牙周状况及口腔Hp感染情况均不佳，且患有牙周炎和口腔Hp感染可能与不良妊娠结局相关，需注意规范孕妇口腔卫生行为的实施（定期洁牙、增加刷牙时间等）及定期检查牙结石、妊娠期呕吐等情况，以及时维护妊娠期牙周健康。

关键词: 牙周炎, 口腔幽门螺杆菌, 影响因素, 妊娠结局

Abstract: Objective    To study the periodontal status and oral Helicobacter pylori（Hp）infection in pregnant women and the associated influencing factors. Methods    Totally 190 pregnant women who underwent regular obstetric checkups at the Affiliated Hospital of North Sichuan Medical College from January to October in 2023 were selected as the study subjects. A self-designed questionnaire was used to investigate the oral hygiene behavior of all pregnant women. Using a combination of visual probing，pregnant women underwent an oral examination to record periodontal conditions such as calculus，bleeding on probing，periodontal attachment level，and probing depth. Hp test paper（dry chemical method）was used to detect oral Hp infection in pregnant women；the incidence of adverse pregnancy outcomes（preterm labor and low birth weight babies）was recorded. Results    The prevalence of periodontitis in pregnant women was 49.5%（94/190）and that of oral Hp infection was 44.7%（85/190）. Dental cleaning within 1 year（OR = 0.238，95%CI：0.108 - 0.527，P < 0.001）and calculus（OR = 2.150，95%CI：1.125 - 4.109，P = 0.021）were independent influencing factors of the development of periodontitis. Brushing for > 3 min at a time（OR = 0.268，95%CI：0.104 - 0.691，P = 0.006），vomiting during pregnancy（OR = 2.165，95%CI：1.147 - 4.088，P = 0.017），and having periodontitis（OR = 2.086，95%CI：1.101 - 3.954，P = 0.024）were independent influencing factors of oral Hp infection. The incidence of adverse pregnancy outcomes was 8.42%，including 10 preterm deliveries and 6 low birth weight babies out of 190 pregnancies.The incidence of adverse pregnancy outcomes in the group with periodontitis and oral Hp infection，the group with periodontitis only，the group with oral Hp infection only，and the group with no periodontitis and no oral Hp infection were，respectively，18.00%（9/50），6.82%（3/44），8.57%（3/35），and 1.64%（1/61），and the difference was statistically significant（P = 0.019）. Conclusion    Pregnant women are often with poor periodontal status and oral Hp infection，and suffering from periodontitis and oral Hp infection may be associated with poor pregnancy outcomes. Attention needs to be paid to the implementation of oral hygiene behaviors（regular tooth cleaning，increasing brushing time）in pregnant women and the conduct of regular examinations of calculus and vomiting during pregnancy to maintain periodontal health during pregnancy.

Key words: periodontitis, oral Helicobacter pylori, influencing factor, pregnancy outcomes