Relationship between Low Birth Weight and Maternal Periodontitis: A Case Study of Kiambu County.

Abstract

Periodontitis is defined as a long-term inflammatory disease of the periodontal ligament and alveolar bone occurring as a response to bacterial plaque. Periodontal diseases are estimated to affect more than 95% of the adult population in Kenya. Low birth weight is defined by the World Health Organization as neonatal birth weight of 2500 g or less, regardless of gestational age. It is estimated to contribute 60 to 80 percent of all neonatal deaths The Kenya Demographic Health Survey (KDHS) of 2014 estimated low birth weight to be 7.6% countrywide and 9.2% in the Central region showing an increase in prevalence by 3.7% in 5 years. In addition, among all early childhood mortality rates in Kenya, neonatal mortality has showed the slowest rate of decline. With the high prevalence of periodontal diseases in females in Kenya and the increase in neonates born with low birth weight in central region, there was need to evaluate if there is a relationship between low birth weight and periodontitis. We further sought to determine the incidence of periodontitis in mothers delivering low birth weight neonates in Kiambu and to evaluate the relationship between low birth weight and oral hygiene practices in the same County. We carried out a cross sectional study using 384 post-partum mothers distributed across five hospitals in Kiambu between June and December 2019. Mothers who had delivered singleton low birth weight neonates within 48 hours, according to the medical records, were enrolled for clinical examinations and interviewed using a structured questionnaire. The incidence of maternal periodontitis in Kiambu was found to be 92% with 53% of the mothers having severe periodontitis. All oral hygiene practices were significantly associated with low birth weight (P0.001). Incidences of maternal periodontitis are significantly associated with low birth weight with an R2 = 0.732, P  0.001 and a correlation of r = 0.875, P  0.001. Statistically significant associations were found between age and maternal periodontitis (p = 0.045), highest level of education and maternal periodontitis (p = 0.007) and dental visits prior to pregnancy and maternal periodontitis (p = 0.012). In conclusion, there is a high incidence of periodontitis in mothers delivering low birth weight neonates in Kiambu County. Poor oral hygiene practices are a potential predictor of low birth weight. A positive relationship exists between low birth weight and maternal periodontitis in this population. The ministry of health should incorporate oral health preventive and curative services in antenatal programs in Kenya. Public health awareness on the importance of proper oral hygiene practices and routine dental care is required especially among expectant women. Large prospective cohort studies are required to investigate the relationship between low birth weight and periodontitis in different populations in the country. Further research is required on misconceptions surrounding dental care during pregnancy and barriers limiting utilization of dental services during pregnancy.