CONDIÇÃO PERIODONTAL GESTANTE - PARCEIRO E RISCO DE VAGINOSE BACTERIANA E PREMATURIDADE

Abstract

Periodontal disease is an independent risk factor for premature birth. The objective of this work is analyze the influence of the periodontal condition of the pregnant woman and her sexual partner in the development of the Bacterial Vaginoses and risk of premature births. An observational, analytical, longitudinal and prospective study was carried out evaluating 71 pregnant woman and 15 sexual partners accompainied during at prenatal care at a basical health unit in Maceio-AL. A form is used to collect social demographic data, sexual habits, past obstetric history, current pregnancy, access to dental services and perception of oral health habits. The vaginal secretion culture, the oral health status of pregnant woman and their partners and the obstetric outcome were evaluated. Data were tabulated in Excel (Microsoft Office®) and summarized in tables and graphs. The results of qualitative variables were expressed through absolute (n) and relative (%) frequencies. For quantitative variables, mean and standard deviation were calculated using “SPPS® Statistics for Windows” software version 20.0. Inferential analysis was conducted using chi-square x2 tests and logistic regression to identify factors associated with preterm birth (dependent variable), with a significance level of 5% (p<0.05). Premature delivery occurred in 25,4% of the pregnant woman, 52,1% were aged 26 years or older, were black or brown, had a monthly income of less than one minimum waged and had steady sexual partners. Of these, 11,3% were smokers and/or drinkers; 91.5% were sexually active, with vaginal sex being the most prevalent (90.1%) and 46.5% had oral sex. Four patients reported previous prematurity. The pathogen most present in vaginal secretion cultures was Gardnerella vaginallis (etiological factors for vaginosis). The patients did not visit the dentist in 64.8% in the last year and 84.5% did not visited the dentist during prenatal care. The use of dental floss was not performed in 53.5%. Regarding oral health, the visible plaque index (risk factor of periodontal disease) was 83.7% in pregnant woman and 90.3% in partners. Since, 76.1% of pregnant woman and 66.7% of partners had periodontitis. The high prevalence of periodontal pockets in pregnant women may help explain the occurrence of premature birth. In carrying out the bivariate analysis, family income > R$ 1.100,00 was statistically associated (p ≤ 0.20) with a higher rate of vaginal delivery. Having a chronic disease was also correlated with a higher risk of PP (p = 0.05). Previous prematurity increased the chance of the patient having a new PP by more than seven times. Carrying out more than six prenatal consultations increased the frequency of PP by about four times. No significant differences were observed between groups regarding periodontal clinic parameters and obstetric outcomes (p > 0.05). In the multiple analysis of logistic regression, none of the factors raised as risk factors for PP was associated with prematurity. The number of survey participants, especially partners, may explain this result.