Date of Award

12-6-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Shafquat Rozi

Second Advisor

Dr. Nadeem Zuberi

Third Advisor

Dr. Murtaza Raza Kazmi

Department

Community Health Sciences

Abstract

Background: Gestational Diabetes Mellitus (GDM) defined as glucose intolerance of varying degree, with first onset or recognition during pregnancy is one of the most common metabolic disorder of pregnancy with an increasing incidence globally. It is reported to be a significant cause of perinatal morbidity with adverse birth and subsequent high risk of type 2 diabetes and obesity in both mother and baby. Periodontal disease (PD) is one of the most common chronic inflammatory disorders affecting the tissues surrounding the teeth has a global prevalence among pregnant women ranging from 11% to 100%. Due to the overlapping aetiology of both the conditions, pregnant women are often at risk of developing both diseases simultaneously.
Aims: This study aims to evaluate the association of periodontal disease and gestational diabetes mellitus (GDM) among post-partum women at private tertiary care hospital of Karachi, Pakistan.
Methodology: Analytical cross sectional study. A sample size of 178 was recruited by nonprobability purposive sampling from postpartum women who delivered within 24 hours at Aga Khan University Hospital, Karachi, Pakistan. The International Association of Diabetes and Pregnancy Study Group criteria was used to diagnose the GDM status.
Results: A total of 101 postpartum women (57%) were diagnosed with periodontal disease and 50 (28%) were GDM positive. Of those who had PD, 35% (n=35/101) were GDM positive. An insignificant association of the prevalence ratio of GDM in women with periodontal disease was found. [PR=1.7; 95% CI: 0.2-3.2; p-value 0.07]. A statistically significant association was found between the prevalence ratio of GDM in women with obesity. It was 2.6 times compared to women who were not obese (p value< 0.007, 95% CI: 1.3-5.1). A subset analysis indicated a significant association of current inflammation (moderate to severe gingivitis [PR=2.2; 95% CI: 1.2 - 4.2; p-value 0.02] and bleeding on probing (>50% sites) [PR=2.1; 95% CI: 1.02-4.4; p-value 0.04]) to the prevalence ratio of GDM in the postpartum women as compared to apparently previous existing periodontal condition (periodontitis [PR=1.8; 95% CI: 0.98-3.2; p-value 0.05]).
Conclusion: There is insignificant association found between the prevalence ratio of GDM in women with periodontal disease in our setting. Upon dissecting the periodontal conditions, the association found between the prevalence ratio of GDM in women with current gingival inflammation (moderate to severe gingivitis and bleeding on probing >50% sites) highlights the need of addressing oral care specially during pregnancy. Women who are overweight or have a tendency to gain weight should be closely monitored and guided to take dietary measures. Timely measures can prevent both periodontal disease and subsequent GDM to avoid unfavourable outcomes, especially in low resource countries such as Pakistan where a dental check-up is not a part of regular antenatal care.

First Page

1

Last Page

71

Download

Share

COinS