Periodontal Disease and Health Related Quality of Life (HRQoL) in Pregnant Women

Hae-jin Park; Haejung Lee; Soohyun Cho

doi:10.4069/kjwhn.2016.22.4.191

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Park, Lee, and Cho: Periodontal Disease and Health Related Quality of Life (HRQoL) in Pregnant Women

Original Article

Korean Journal of Women Health Nursing 2016; 22(4): 191-201.

Published online: 27 December 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.4.191

Periodontal Disease and Health Related Quality of Life (HRQoL) in Pregnant Women

Hae-jin Park¹, Haejung Lee², Soohyun Cho³

¹College of Nursing, Pusan National University, Yangsan · Ilsin Christian Hospital, Busan, Korea.

²College of Nursing, Pusan National University, Yangsan, Korea.

³Ilsin Christian Hospital, Busan, Korea.

Corresponding author: Lee, Haejung. College of Nursing, Pusan National University, 49 Beomeo-ri, Mulgeum-eup, Yangsan 50612, Korea. Tel: +82-51-510-8344, Fax: +82-51-510-8308, haejung@pusan.ac.kr

Received 30 April 2016 Revised 28 August 2016 Accepted 2 November 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify relationships of periodontal disease and health related quality of life (HRQoL) in pregnant women.

Methods

The participants in this study were 129 pregnant women. Data were collected using questionnaires of characteristics of the participants and subjective perception of periodontal disease and a dentist's assessment of periodontal disease. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression.

Results

The physical QoL showed significant negative correlation with subjective perception of periodontal disease (r=-.21, p=.013). Mental QoL had significant negative correlations with subjective perception of periodontal disease (r=-.32, p<.001) and objective periodontal disease (r=-.34, p<.001). Hierarchical multiple regression analyses revealed that pregnant women who had a history of abortion and had higher subjective perception of periodontal disease tended to report lower levels of physical QoL. Pregnant women whose age are between 30-34 years and higher subjective perception and objective periodontal disease tended to report lower mental QoL.

Conclusion

To improve HRQoL of pregnant women, nurses should pay attention on the status of periodontal disease. Careful assessment of oral healthy behaviors and proper intervention for oral health of pregnant women are needed to enhance HRQoL of pregnant women.

Keywords: Pregnant women, Periodontal diseases, Quality of life

Figures and Tables

Table 1

Differences in Health related Quality of Life according to Socio-demographic and Obstetric Characteristics and Periodontal Disease (N=129)

Variables			Categories	n (%) or M±SD	PCS		MCS
Variables		M±SD	Categories	n (%) or M±SD	t or F (p)	M±SD	t or F (p)
Age (yr) (range=20~40)		<30^a	33 (25.5)	43.58±4.43	0.72 (.485)	52.06±9.86	5.17 (.007) b<c^†
		30~34^b	65 (50.3)	43.64±5.96		47.39±9.77
		≥35^c	31 (24.2)	42.34±3.86		53.89±10.92
		≥35^c	31.97±3.75	42.34±3.86		53.89±10.92
Education		≤High school	21 (16.2)	41.52±5.76	1.65 (.196)	52.51±7.49	0.69 (.503)
		College	42 (32.5)	43.36±4.63		50.02±11.23
		≥4 year university	66 (51.3)	43.85±5.19		49.46±10.59
Monthly family income (10,000 won)		<200	4 (3.2)	42.05±4.29	0.09 (.964)	54.44±6.93	0.84 (.472)
		200~299	30 (23.2)	43.20±4.02		47.78±8.76
		300~399	47 (36.4)	43.41±6.06		50.58±9.74
		≥400	48 (37.2)	43.39±4.97		50.83±11.96
		≥400	349.53±112.65	43.39±4.97		50.83±11.96
Pre-pregnancy BMI (Kg/m²)		＜18.5	7 (5.4)	45.04±4.05	1.93 (.128)	42.22±5.50	1.72 (.166)
		18.5~22.9	89 (68.9)	42.63±5.30		50.49±10.45
		23.0~24.9	19 (14.7)	45.40±4.30		49.56±12.75
		≥25.0	14 (11.0)	43.92±5.07		52.66±6.07
		≥25.0	21.85±2.85	43.92±5.07		52.66±6.07
Regular exercise		Yes	40 (31.0)	43.07±3.80	0.10 (.745)	51.24±10.79	0.53 (.465)
Regular exercise		No	89 (69.0)	43.40±5.58	0.10 (.745)	49.73±10.22	0.53 (.465)
Gestation period (trimester)		1st	40 (31.0)	52.96±3.62	1.85 (.161)	47.15±3.62	0.38 (.680)
		2nd	44 (34.1)	43.23±2.11		45.96±3.62
		3rd	45 (34.8)	41.96±3.23		52.23±5.23
Pregnancy disease		PIH	4 (3.1)	40.51±5.21	0.82 (.443)	56.99±4.81	1.48 (.231)
		G-DM	15 (11.6)	42.59±3.98		47.24±9.42
		None	110 (85.3)	43.51±5.28		50.21±10.54
Number of pregnancies		Primigravida	60 (46.5)	42.73±5.17	1.42 (.236)	49.97±9.60	0.01 (.932)
Number of pregnancies		Multigravida	69 (53.5)	43.82±5.10	1.42 (.236)	50.21±9.58	0.01 (.932)
History of abortion		≥1	19 (14.8)	39.73±5.87	11.66 (.001)	50.32±10.50	0.22 (.634)
		No	110 (85.2)	43.93±4.77		49.09±9.73
		No	0.16±0.41	43.93±4.77		49.09±9.73
PD	Self-reported	<6	107 (70.4)	43.79±5.28	5.65 (.019)	51.22±9.87	7.17 (.008)
		≥6	22 (14.5)	40.98±3.66		44.87±11.27
		≥6	4.43±2.27	40.98±3.66		44.87±11.27
	Objective periodontal disease^‡	Healthy^a	29 (22.5)	43.69±4.94	8.21 (.442)	58.94±8.59	17.37 (<.001) a<b, c^†
		Gingivitis^b	52 (40.3)	43.80±6.18		48.40±9.73
		Periodontitis^c	48 (37.2)	43.31±5.14		43.70±9.07
		Periodontitis^c	2.53±2.05^‡	43.31±5.14		43.70±9.07
Total				43.32±5.15			50.14±10.36

PCS=physical component summary score; MCS=mental component summary score; PIH=pregnancy induced hypertension; G-DM=gestational diabetes mellitus; PD=periodontal disease; ^†Scheffè test; ^‡Periodontal probing depth (mm).

Table 2

Relationships among Socio-demographic, Periodontal Disease and Health related to Quality of Life (N=129)

Variables		X1	X2	X3	X4	X5	X6	X7	X8
Age (yr)	(X1)	1
Gestation period	(X2)	.13	1
Monthly family income	(X3)	.21^*	.05	1
Pre-pregnancy BMI	(X4)	.17^*	-.13	-.01	1
Periodontal disease
Self-reported	(X5)	.14	.37^**	-.10	-.01	1
Objective^†	(X6)	.13	.57^**	-.02	-.04	.63^**	1
Health-related quality of life
SF-12: PCS	(X7)	-.13	-.16	.07	.06	-.21^*	-.11	1
SF-12: MCS	(X8)	.05	-.09	.13	.15	-.32^**	-.34^**	-.16	1

^*p<.05, ^**p<.01; BMI=body mass index, PCS=physical component summary score, MCS=mental component summary score; ^†Periodontal probing depth (mm).

Table 3

Unique Contribution of Periodontal Disease in Explaining Physical Component of Quality of Life in Pregnant Women (N=129)

Variables	Categories	Model 1				Model 2
Variables	Categories	B	SE	β	t (p)	B	SE	β	t (p)
Age	<30^†	1.28	1.28	.11	1.00 (.318)	0.92	1.27	.07	7.24 (.470)
Age	30~34^†	1.03	1.11	.10	0.93 (.354)	0.66	1.11	.06	0.59 (.552)
Education	≤High school^†	-2.53	1.28	-.18	-1.97 (.051)	-2.07	1.29	-.15	-1.60 (.110)
Education	College^†	-0.92	1.00	-.08	-0.91 (.364)	-1.06	1.00	-.09	-1.06 (.291)
Monthly family income		0.01	0.01	.02	0.31 (.756)	7.84	0.01	.00	0.01 (.984)
Pre-pregnancy BMI		0.23	0.16	.13	1.46 (.146)	0.22	0.16	.12	1.42 (.156)
Gestation period		-0.04	0.04	-.09	-1.08 (.281)	-0.04	0.05	-.09	-0.92 (.357)
Had a history of abortion^†		-3.88	1.26	-.26	-3.07 (.003)	-4.43	1.27	-.30	-3.47 (.001)
Self-reported periodontal status						-0.62	0.25	-.27	-2.43 (.016)
Objective periodontal disease^‡						0.43	0.32	.17	1.33 (.183)
R²		.142				.183
Adj. R²		.085				.114
F (p)		2.48 (.016)				2.64 (.006)
R² change		-				.041
F (p) for R² change		-				2.97 (.055)

^†Dummy variables: 35 years and above, 4 year university graduates and above, no history of abortion are reference values; ^‡Periodontal probing depth (mm).

Table 4

Unique Contribution of Periodontal Disease in Explaining Mental Component of Quality of Life in Pregnant Women (N=129)

Variables	Categories	Model 1				Model 2
Variables	Categories	B	SE	β	t (p)	B	SE	β	t (p)
Age	<30^†	-1.69	2.62	-.07	-0.64 (.519)	-3.09	2.40	-.13	-1.28 (.201)
Age	30~34^†	-6.76	2.28	-.32	-2.96 (.004)	-7.63	2.09	-.37	-3.64 (<.001)
Education	≤High school^†	2.71	2.61	.09	1.03 (.303)	1.92	2.43	.06	0.79 (.431)
Education	College^†	0.29	2.05	.01	0.14 (.888)	-1.42	1.90	-.06	-0.74 (.456)
Monthly family income		0.00	0.00	.04	0.48 (.634)	-0.00	0.00	-.02	-0.27 (.788)
Pre-pregnancy BMI		0.34	0.33	.09	1.04 (.300)	0.37	0.30	.10	1.22 (.225)
Gestation period		-0.11	0.08	-.12	-1.34 (.183)	0.11	0.09	.11	1.18 (.237)
Had a history of abortion^†		-1.68	2.58	-.05	-0.65 (.514)	-1.31	2.41	-.04	-0.57 (.585)
Self-reported periodontal status						-1.19	0.48	-.26	-2.48 (.014)
Objective periodontal disease^‡						-1.42	0.60	-.28	-2.33 (.021)
R²		.119				.282
Adj. R²		.060				.221
F (p)		2.07 (.049)				4.63 (＜.001)
R² change		-				.163
F (p) for R² change		-				13.39 (<.001)

^†Dummy variables: 35 years and above, 4 year university graduates and above, no history of abortion are reference values; ^‡Periodontal probing depth (mm).

Notes

^{CONFLICTS OF INTEREST} The authors declared no conflict of interest.

Summary Statement

▪ What is already known about this topic?

Periodontal disease is a common oral infection in pregnant women with high prevalence ranging from 50~75%.

▪ What this paper adds?

This study showed high risk of periodontal disease among pregnant women, reporting 40.3% of gingivitis and 37.2% of periodontitis, which also related to quality of life in pregnant women.

▪ Implications for practice, education and/or policy

Since oral health care is highly related to periodontal disease and quality of life in pregnant women, intensive screening for oral health problems in pregnant women should be considered as routine perinatal care and nationwide advertisement of the important of oral hygiene during pregnancy is essential.

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