妊娠期口腔健康行为对子痫前期发生的影响研究

A study on the influence of oral health behaviors during gestation on the development of preeclampsia

摘要

目的 本研究旨在探索孕妇妊娠期口腔健康行为与子痫前期发生之间的关联,为子痫前期的口腔健康相关病因探究和预防策略的制定提供科学依据。方法 本研究采用病例对照设计,选取2022年1月至12月期间在西北妇女儿童医院进行产前检查的孕妇作为研究对象.将诊断为子痫前期的孕妇纳入病例组(n=128),同时选取同期健康孕妇纳入对照组(n=748).通过调查问卷及口腔健康影响程度量表-14(OHIP-14)收集研究对象的一般信息、口腔健康行为及口腔健康相关生活质量水平等资料.采用多因素Logistic回归分析探究口腔健康行为对孕妇子痫前期发生的影响。结果 相比对照组,子痫前期组的高龄孕妇、孕前超重及肥胖、家庭年收入处于较低水平以及试管受孕的比例均较高(χ²值的范围在24.692~46.845之间,均P<0.05);子痫前期组的孕妇在经常饭后漱口、很少刷牙后进食、使用牙线、口腔不适时按时就诊、刷牙次数≥2次/d,刷牙时间≥3分钟/次等健康口腔行为方面的比例均低于对照组(χ²值的范围在4.429~12.509之间,均P<0.05);两组间OHIP-14量表评分显示子痫前期组孕妇在疼痛与不适(2.65 vs. 1.77)、功能受限(1.98 vs. 1.19)、独立能力减弱(1.90 vs. 1.07)3个维度的得分及总得分(8.11 vs. 5.39)均高于对照组,差异有统计学意义(t/Z值分别为-5.249、-7.593、-5.083、-6.373,均P<0.05);多因素Logistic回归分析结果显示孕妇妊娠期间使用牙线(OR=0.49,95%CI:0.27~0.89)及口腔不适时按时就诊(OR=0.40,95%CI:0.21~0.80)会降低子痫前期的发生风险,而高OHIP-14得分(OR=1.09,95%CI:1.05~1.14)则会增加子痫前期的发生风险。结论 孕妇在妊娠期的不良口腔健康习惯可能会导致妊娠期子痫前期的发生风险增加,应加强围孕期口腔健康教育与指导,从而有效降低孕期不良口腔健康行为所带来的潜在风险,促进母婴健康.

Abstract

Objective The purpose of this study was to explore the association between oral health behaviors and the occurrence of preeclampsia in pregnant women, and to provide a scientific basis for the exploration of oral health-related etiology and the formulation of prevention strategies for preeclampsia. Methods In this study, a case-control design was used to select pregnant women who underwent antenatal care at Northwest Women and Children's Hospital from January to December 2022. Pregnant women diagnosed with preeclampsia were included in the case group (n=128), and healthy pregnant women were included in the control group (n=748). The questionnaire and the Oral Health Impact Scale-14 (OHIP-14) were used to collect general information, oral health behaviors, and oral health-related quality of life levels of the study subjects. Multivariate logistic regression analysis was used to explore the effect of oral health behavior on the occurrence of preeclampsia in pregnant women. Results Compared with the control group, the preeclampsia group had higher elderly pregnant women, higher pre-pregnancy overweight and obesity, higher family annual income at a lower level, and a higher proportion of IVF (χ ² value ranged from 24.692 to 46.845, all P<0.05). The proportion of inferior healthy oral behaviors was lower than that of the control group (χ² values ranged from 4.429-12.509, all P<0.05). The OHIP-14 scale score between the two groups showed that the scores and total scores (8.11 vs. 5.39) of pain and discomfort (2.65 vs. 1.77), functional limitation (1.98 vs. 1.19), and impaired independence (1.90 vs. 1.07) in the preeclampsia group were higher than those in the control group, and the difference was statistically significant (t/Z values were -5.249, -7.593, -5.083, -6.373, all P<0.05). The results of multivariate logistic regression analysis showed that flossing (OR=0.49, 95%CI: 0.27-0.89) and oral discomfort during pregnancy (OR=0.40, 95%CI: 0.21-0.80) reduced the risk of preeclampsia, while high OHIP-14 score (OR=1.09, 95%CI: 1.05-1.14) increased the risk of preeclampsia. Conclusion Poor oral health habits of pregnant women during pregnancy may lead to an increased risk of preeclampsia during pregnancy, and oral health education and guidance during periconception should be strengthened to effectively reduce the potential risks caused by poor oral health behaviors during pregnancy and promote maternal and infant health.

关键词

妊娠期 / 口腔健康行为 / 口腔健康相关 / 生活质量 / 子痫前期 / 病例对照研究

Key words

gestation period / oral health behavior / oral health-related quality of life / preeclampsia / case-control study

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基金资助

国家自然科学基金(82103924)

陕西省重点研发计划(2024SFGYBXMＧ238)

西安市科技计划项目(20YXYJ0005(8))