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Master's Dissertation
DOI
https://doi.org/10.11606/D.25.2018.tde-03092018-145549
Document
Author
Full name
Gerson Aparecido Foratori Júnior
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2018
Supervisor
Committee
Peres, Sílvia Helena de Carvalho Sales (President)
Dalben, Gisele da Silva
Damante, Carla Andreotti
Meneghim, Marcelo de Castro
Title in Portuguese
Avaliação da condição periodontal, e seu impacto na qualidade de vida, de pacientes com excesso de peso pré-gestacional antes e após o parto
Keywords in Portuguese
Gravidez
Obesidade
Periodontite
Qualidade de vida
Sobrepeso
Abstract in Portuguese
Este estudo observacional e longitudinal avaliou a condição periodontal em gestantes com excesso de peso pré-gestacional durante os 2º e 3º trimestres da gestação e após o parto. No 2º trimestre (T1) gestacional as gestantes(n=93) foram divididas em: gestantes com excesso peso (GPE=53) e com peso normal (GPN=40) e posteriormente examinadas no 3º trimestre de gestação (T2) e após, no mínimo, 2 meses do parto (T3). As pacientes foram avaliadas: a) Acometimentos sistêmicos na gestação - Hipertensão Arterial [HAr], Diabetes Mellitus Gestacional [DMG] e anemia (T1, T2 e T3); b) Ganho ponderal na gestação (T3); c) Condição periodontal - periodontite, gengivite e cálculo dentário (T1, T2 e T3); d) Qualidade de vida - Questionário Oral Health Impact Profile adaptado [OHIP-14] (T1 e T3); e) Dados antropométricos e condição de saúde sistêmica após a gestação. Teste t, Mann-Whitney, Qui-quadrado, Kruskal-Wallis e regressão logística (Stepwise Forward) foram adotados (p<0,05). GPE mostraram maior frequência de DMG e HAr, no T1 e T2, respectivamente (p= 0,047 e p=0,004). GPE mostraram no T2 ganho ponderal total acima do esperado (p=0,019). Maior frequência de periodontite foi encontrada em todos os períodos para GPE (p<0,05). Houve diferença entre os grupos para gengivite apenas em T2 (p=0,011), sendo maior no grupo de GPE. GPN mostraram melhora de todos os parâmetros periodontais após o parto, enquanto GPE não mostraram diferença com relação a esses parâmetros entre os períodos. Não houve diferenças entre os grupos em T1 e T3 quanto as dimensões e escore total do OHIP-14. Entretanto, três dimensões e o escore total do OHIP-14 melhoraram após o parto para ambos os grupos. No pós-termo, o grupo de GPE mostrou maior IMC, maior relação cintura-quadril e maior risco de desenvolvimento de doenças cardiovasculares. A regressão logística mostrou que gestantes com periodontite no 3º trimestre e após o parto apresentaram, respectivamente, 4,28 e 11,70 mais chances de terem excesso de peso. Conclui-se que GPE apresentam piores condições sistêmica e periodontal na gestação e após o parto, sendo que a periodontite está intimamente ligada ao excesso de peso. Além disso, a presença de gengivite e periodontite durante a gestação impactam negativamente na qualidade de vida dessas pacientes.
Title in English
Analysis of periodontal condition, and its impact on quality of life, in pregnant women with pre-pregnancy excessive weight before and after delivery
Keywords in English
Obesity
Overweight
Periodontitis
Pregnancy
Quality of life
Abstract in English
This observational and longitudinal study evaluated the periodontal condition in pregnant women with pre-pregnancy overweight/obesity during the 2nd and 3rd trimesters of gestation and after delivery. In 2nd gestational trimester (T1), pregnant women (n=93) were divided into: pregnant women with excessive weight (PEW=53) and normal weight (PNW=40) and subsequently examined in 3rd trimester (T2) and, at least, 2 months after delivery (T3). Patients were evaluated: a) Systemic compromises during pregnancy - Arterial Hypertension [AH] Gestational Diabetes Mellitus [GDM] and anemia (T1, T2 and T3); b) Gestational weight gain (T3) c) Periodontal condition - periodontitis, gingivitis and dental calculus (T1, T2 and T3); d) Quality of life - Oral Health Impact Profile Questionnaire [OHIP-14] (T1 and T3); e) Anthropometric and systemic health condition after gestation. T test, Mann-Whitney, Chi-square, Kruskal-Wallis and logistic regression (Stepwise Forward) were adopted (p<0.05). PEW showed higher frequency of DMG and AH in T1 and T2, respectively (p=0.047 and p=0.004). In T2 PEW showed excessive weight gain, above that expected (p=0.019). Higher frequency of periodontitis was found in all periods for PEW (p<0.05). There were differences between groups regarding gingivitis only in T2 (p=0.011), being higher in PEW. PNW showed improvement of all periodontal parameters after delivery, whereas PEW showed no difference of these parameters between periods. There were no differences between groups in T1 and T3 regarding OHIP-14 overall score. However, three dimensions and total OHIP-14 score improved after delivery for both groups. In T3, PEW showed higher BMI, waist-hip ratio and risk of developing cardiovascular diseases. Logistic regression showed that pregnant women with periodontitis in the 3rd trimester and after delivery were, respectively, 4.28 and 11.70 more likely to be overweight. It can be concluded that PEW present worse systemic and periodontal conditions during pregnancy and after delivery, and periodontitis is closely related to excess weight. In addition, worst oral condition during pregnancy negatively impacts quality of life of the patients.
 
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Release Date
2020-09-03
Publishing Date
2018-09-12
 
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