口腔衛生に関する知識と母体の口腔衛生状態と産科リスクおよび母乳育児との関連性

Relationship between Oral Health Knowledge and Maternal Oral Health with Obstetric Risk and Breastfeeding.

抄録

母親の歯肉の健康状態と低出生体重児や早産との関係については議論のあるところである。本研究の目的は、母親の口腔に関する知識と妊娠中の口腔の健康レベルと産科合併症のリスクおよび母乳育児との関連を分析することであった。97名の妊婦の連続サンプルを対象に、口腔衛生教育介入後に記述的横断研究を実施した。データ収集は，有効な質問票，口腔内診査，Caries Index（CAOD），Simplified Oral Hygiene Index（IHOS）から構成された．参加者の平均年齢は 32.5±5.19 歳で，学歴は主に大学であった（57.1％）．口腔衛生に関する知識レベルはまあまあであった（正解率 12.5 ± 3.56）．高齢の妊婦（33.0±4.80歳）は母乳育児を実践しており，質問票の正答率も高かった．十分なIHOSは高出生体重新生児（3333±0.3）と関連したが，口腔衛生管理不良は低出生体重新生児（2960±0.1）と関連した（＜0.05）．学歴の低さは口腔衛生状態の悪化と関連した（< 0.05）．また、子供の数が多いほど、CAODは高くなった。最後に、非喫煙女性では、乳児の体重は437mg高かった。母親の口腔衛生状態および出産週は、重回帰モデルにおいて、新生児体重と関連していた（< 0.05）。また，喫煙は低出生体重児と関連していた（< 0.05）．産科的副作用の発生を減少させ，母親とその子どもの口腔衛生を改善するためには，妊娠中の教育的介入が必要である．

The relationship between maternal gingival health status and low birth weight or preterm delivery is controversial. The aim of this study was to analyze the association between maternal oral knowledge and the level of oral health during pregnancy with the risk of obstetric complications and breastfeeding. A descriptive cross-sectional study was conducted after an oral health educational intervention in a consecutive sample of 97 pregnant women. Data collection consisted of a validated questionnaire, oral examination, the Caries Index (CAOD) and the Simplified Oral Hygiene Index (IHOS). The participants had a mean age of 32.5 ± 5.19 years and a predominantly university education (57.1%). The level of knowledge regarding oral health was fair (12.5 ± 3.56 correct answers). Older pregnant women (33.0 ± 4.80 years) practiced breastfeeding and had a higher number of correct answers to the questionnaire. Adequate IHOS was associated with higher birth-weight newborns (3333 ± 0.3), whereas poor oral hygiene control was associated with lower birth-weight newborns (2960 ± 0.1) ( &lt; 0.05). A lower level of academic education was associated with worse oral hygiene ( &lt; 0.05). In addition, the greater the number of children, the higher the CAOD. Finally, among non-smoking women, the weight of infants was 437 mg higher. Maternal oral hygiene and the week of delivery were associated with newborn weight ( &lt; 0.05) in a multiple linear regression model. Smoking was also related to low birth weight ( &lt; 0.05). Educational interventions in pregnancy are necessary to decrease the incidence of obstetric adverse effects and improve the oral health of mothers and their children.