Maternal periodontal disease as a significant risk factor for low birth weight in pregnant women attending a secondary care hospital in South India: A Case-control study.

Context: Periodontal disease (PD) is a common infection in the community; however, its relationship with low birth weight (LBW) has not been well‑established. Aims: The aim was to determine the association between maternal PD and LBW. Settings and Design: A case–control (1:1) study. Materials and Methods: The study population comprised of women who delivered at the hospital during the study period (September 2011 to February 2012).Women between 18 and 35 years of age, who delivered singleton, live infants during study period with at least 18 teeth were enrolled. Those with pregnancy induced hypertension, gestational diabetes, blood‑borne viral infections, periodontal treatment within the past 6 months and valvular heart disease were excluded. Control population was parity matched to the cases. Statistical Analysis Used: Chi‑square test, t‑test and univariant and multivariant logistic regression were used to analyze various study findings, and level of significance was set at 5% (P < 0.05). Results: PD was independently associated with LBW (odds ratio: 4.94, 95% confidence interval: 1.03–23.65, P=0.045). Additionally, conventional risk factors such as maternal height (P=0.029), secondary schooling (<8 years of schooling) (P = 0.001), socio‑economic status (P = 0.046), type of family (joint) (P = 0.008), number of ante‑natal visits (P = 0.028) and gestational age at birth (<37 weeks) (P = 0.045) showed significant association with LBW. Conclusions: There seems to be an association between PD and LBW independent of conventional risk factors. Women who had PD were 5 times more likely to deliver LBW infants.

Antibody response to a single tetanus toxoid booster in young women in rural south India.

BACKGROUND: Tetanus toxoid immunization is an integral part of the maternal and child health programme in developing countries. It is likely that many women may have had childhood immunization and so already have antitetanus antibodies at the time of their first antenatal visit. A single dose of tetanus toxoid injection can boost the levels of antitetanus antibodies in these women. This study was undertaken to assess the previous immunization status by verbal history and assess the effect of a single tetanus toxoid injection in young women. METHODS: Ninety-nine unmarried women between 18 and 22 years of age were enrolled for the study. The history of childhood immunization was obtained from their mothers. Blood samples were collected to measure IgG antibody levels to tetanus using ELISA. Antibody levels were also measured on day 14 after a dose of tetanus toxoid injection. RESULTS: Of the 99 women studied, 81 had a history of childhood immunization while 18 did not. Overall, 92% of the women had protective levels of antibodies at the time of first testing and 99% of the women were protected with a single dose of tetanus toxoid. CONCLUSION: In areas with good maternal and child health services, a single booster dose of tetanus toxoid can be considered adequate for primigravidae with a history of childhood immunization.

A high rate of caesarean sections in an affluent section of Chennai: is it cause for concern?

BACKGROUND: While rising Caesarean section rates have been the subject of much attention and debate worldwide, there is not much information available on this rate and its potential adverse impact in India. METHODS: Our survey was a standard Expanded Programme on Immunization 30-cluster design, carried out in an urban educated, middle/upper class population in Chennai. Mothers of 210 children aged 12-36 months were interviewed and data collected on immunization and breast-feeding practices. Since the mode of delivery was one of the questions, we could generate population-based data on the Caesarean section rate and its influence on breast-feeding. RESULTS: Of the 210 babies, 95 (45%, 95% confidence interval: 39.1-51.3) had been delivered by Caesarean section. Two hundred and six of 210 babies (98%) had been breast-fed at some time. However, babies born by Caesarean section tended to be started late on breast-feeds were given prelacteal feeds more often, and colostrum less often when compared to babies delivered vaginally (all statistically significant). CONCLUSIONS: Our study revealed a very high rate of Caesarean section in the selected metropolitan population. On purely scientific grounds, a rate of 40% to 50% is extremely difficult to justify. Though not conclusive, the data also suggest that Caesarean section may be adversely affecting some aspects of breast-feeding. There is a need for more data and audits on Caesarean section rates in India, and a wider debate on its potential adverse impact on the health of mothers and newborns.