Oropharyngeal colostrum immunotherapy and risk reduction of mortality in very low birth weight premature newborns: a clinical trial.

OBJECTIVE: To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). METHOD: Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. RESULTS: The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p = 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. CONCLUSION: The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.

Oropharyngeal colostrum immunotherapy and risk reduction of mortality in very low birth weight premature newborns: a clinical trial

Abstract Objective To evaluate the effect of oropharyngeal colostrum immunotherapy (OCI) on the mortality of preterm newborns (PTNB) with very low birth weight (VLBW). Method Non-randomized clinical trial, carried out with 138 mother-child pairs attended at a public maternity hospital. The treatment group used raw colostrum, dripping 4 drops (0.2 ml) into the oropharyngeal mucosa, totaling 8 administrations in 24 h, up to the 7th complete day of life (OCI). The control group was composed of newborns admitted to the same maternity hospital before the implementation of the OCI. Analyzes were performed: descriptive, bivariate, multiple logistic regression, and survival analysis, with a significance level of 5% and 95% CI. Results The treatment group had an RR of death of 0.26 (95% CI = 0.07-0.67; p= 0.00), adjusted for maternal age, marital status, gestational hypertension, type of delivery, number of prenatal visits, and birth weight. Number Needed to Treat (NNT) demonstrated that for every 5 individuals treated with OCI, one death was prevented NNT = 4.9 (95% CI = 1.84-5.20); however, for PTNB with VLBW who remained hospitalized for 50, 100 and 150 days, the NNT reduces to 4, 4 and 3, respectively. Conclusion The OCI proved to be a beneficial intervention, since it reduced the risk of mortality in PTNB with VLBW when compared to the control group.

Periodontitis and its higher levels of severity are associated with the triglyceride/high density lipoprotein cholesterol ratio.

BACKGROUND: Periodontitis and the Triglyceride/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio have both been associated with cardiovascular disease, metabolic syndrome, and obesity. Additionally, the ratio is a possible substitute for predicting insulin resistance. This study investigated the association between periodontitis, its severity levels (exposures), and the TG/HDL-C ratio (outcome). METHODS: A cross-sectional study of public health service users in Brazil considered socioeconomic-demographic characteristics, lifestyle behavior, and general and oral health conditions. Anthropometric measurements and blood pressure were also measured. Systemic biomarker data were obtained, as well as assessment of periodontal diagnosis and its severity. The TG/HDL-C ratio was calculated using the serum triglyceride level over HDL cholesterol and the cut-off point, TG/HDL-C ≥2.3 serving as the cutoff indicting dyslipidemia. Logistic and linear regressions were used to statistically analyze the data. RESULTS: A total of 1011 participants were included, with 84.17% having periodontitis and 49.85% having a TG/HDL-C ratio ≥2.3. For individuals with periodontitis, the odds of TG/HDL-C ratio ≥2.3 were 1.47 times greater than in those without periodontitis (ORAdjusted  = 1.47, 95% CI: 1.02-2.14). Similar results were found for those with moderate and severe periodontitis, with a slight increase in the measurement magnitude with disease severity. CONCLUSION: A positive relationship between periodontitis and the TG/HDL-C ratio ≥2.3 was found, suggesting a possible association with periodontal disease severity.

Prevalence of overweight and obesity and associated factors among women of childbearing age in Brazil.

OBJECTIVE: To assess the factors associated with overweight and obesity among women of childbearing age in Brazil. DESIGN: Cross-sectional study. SETTING: Using the National Health Survey (PNS) database, from the year 2013. The socio-economic and demographic factors analysed were age, race/skin colour, region, marital status, education level, employment and family income. Concerning health history, diagnoses of hypertension, diabetes mellitus, high cholesterol, heart attack, stroke, chronic kidney disease, menarche, parity and depression were evaluated. For lifestyle information, health status, alcoholic beverage consumption, smoking and physical activity were included. The outcomes were obesity and overweight. The association of excess weight with socio-economic and demographic factors, health history and lifestyle characteristics was investigated according to the appropriate theoretical-conceptual model for the topic. PARTICIPANTS: The sample size was 17 109 women aged 18-49 years. RESULTS: The prevalence of women with excess weight was 55·20 %, with 33·26 % being overweight and 21·94 % with obesity. The factors associated with excess weight were age, non-white skin colour, having a partner, family income of up to two minimum wages, menarche before the age of 12, multiparity, diabetes mellitus, depression, hypertension, high cholesterol, stroke and heart attack. CONCLUSION: The results showed an association between excess weight and socio-demographic factors, both determinants of general and reproductive health history. Implementation of effective public health policies is necessary to prevent unfavourable outcomes related to the health of women of childbearing age with excess weight.

Indexes to assess feeding practices of children under 2 years old: a systematic review.

OBJECTIVE: To systematically review studies that used indexes to assess feeding practices of children under 2 years. DESIGN: Seven databases were searched with no limit on language or publication date. SETTING: The reviewed studies included thirteen Asian, ten Latin American, four European, four North American, three Oceanian and three African. PARTICIPANTS: Children under 2 years. RESULTS: We analysed thirty-six studies: twenty-two presenting original indexes and fourteen using adapted indexes. Among the original indexes, thirteen assess breast-feeding, fourteen food consumption, ten food groups, and ten other feeding practices. Original indexes were mainly adapted to fit the data available in the study, to update for current nutritional recommendations or to add components not present in the original indexes. Seven studies evaluated the associations between the indexes and nutrient intake or nutritional status. The main limitations cited by the authors were: flaws in the definition of the index components, criteria for cut-off points and weighting of the evaluated index components. CONCLUSIONS: The assessment of feeding practices for young children and its comparison across countries remains a challenge, especially due to the lack of consensus on the construction of indexes and regional differences in dietary recommendations and practices. Lack of validation for some indexes also makes it difficult to choose the most appropriate index for a given objective. Adapting existing indexes is a viable option. We point out relevant recommendations that may contribute to future research. Validation and longitudinal studies in diverse populations are favourable to qualify the assessment of feeding practices in this group.

Moderate and severe periodontitis are positively associated with metabolic syndrome.

OBJECTIVE: This study investigated the association between periodontitis severity (exposure) and metabolic syndrome (MetS - outcome), using two criteria for diagnosis of the outcome, since this relationship remains unexplored. MATERIALS AND METHODS: A case-control study was conducted with 870 individuals: 408 with first MetS diagnosis (cases) and 462 without MetS (controls). Participants' general information was obtained using a questionnaire and laboratory data was collected from medical records. Periodontitis severity criteria followed the Center for Disease Control and Prevention: none, mild, moderate, and severe. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined by logistic regression analysis. RESULTS: Findings showed a positive association between moderate and severe periodontitis and MetS: ORadjusted = 1.64 (95% CI: 1.01 to 2.68) and ORadjusted = 1.94 (95% CI: 1.19 to 3.16), respectively, after adjustment for age, sex, schooling level, smoking habit, and cardiovascular disease. The adjusted measurements showed that among individuals with moderate or severe periodontitis, the probability of having MetS was around two times greater than among those without periodontitis, and that the chance was greater among participants with severe periodontitis than those with moderate periodontitis. CONCLUSION: An association between the severity of periodontal status and MetS was found, suggesting a possible relationship between the two diseases. CLINICAL RELEVANCE: MetS influences the etiology of cardiovascular diseases, one of the leading causes of mortality worldwide. The findings suggest that the greater the severity of periodontitis, the greater is the association magnitude with MetS. The health professional needs to recognize that the importance of periodontal disease may play in MetS.

Severe and moderate periodontitis are associated with acute myocardial infarction.

BACKGROUND: An association between periodontitis and cardiovascular disease is now well documented; however, the effect of periodontitis severity levels on this outcome, specifically on acute myocardial infarction (AMI), remains unexplored. This study investigated the association between levels of periodontitis severity (exposure) and AMI (outcome). METHODS: This case-control study, matched by sex and age, was conducted with 621 participants, with 207 individuals treated in the emergency department of Santa Izabel and Ana Nery Hospitals in Salvador, Bahia, Brazil, diagnosed with a first AMI event, and compared to 414 individuals without a diagnosis of AMI. Levels of periodontitis severity followed two criteria: (1) Center for Disease Prevention and Control and American Academy of Periodontology; (2) Gomes-Filho et al. (2018) using criteria that also evaluated bleeding upon probing. Conditional logistic regression analysis was performed and odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained. RESULTS: The adjusted association measurements showed a positive association between both severe (ORadjusted ranged from 2.21 to 3.92; 95% CI ranged from 1.03 to 10.05) and moderate periodontitis (ORadjusted ranged from 1.96 to 2.51; 95% CI ranged from 1.02 to 6.19), and AMI, for both periodontitis diagnostic criteria. It demonstrated that among those with moderate and severe periodontitis, the chance of having AMI was approximately two to four times greater than among those without periodontitis. CONCLUSION: The findings demonstrate that there is an association between the severity of the periodontal condition and AMI, suggesting a possible relationship among the levels of periodontitis severity and the cardiovascular condition.

Common mental disorder is associated with periodontitis.

OBJECTIVES: This research evaluated the association between exposure to common mental disorder (CMD) and the presence of periodontitis. BACKGROUND: Common mental disorder is characterized by the presence of irritation, fatigue, insomnia, forgetfulness, decreased ability to concentrate, anxiety, and depression. It has been associated with several diseases; however, there are few studies that have associated it with periodontitis. METHODS: This cross-sectional study was carried out with 621 individuals. Data collection involved the application of a general questionnaire and the self-reporting questionnaire for diagnosis of CMD. The diagnosis of periodontitis involved a full mouth periodontal examination using: clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios and 95% confidence intervals between CMD (exposure) and periodontitis (outcome) were obtained. RESULTS: In the final sample, 38.16% (237) of the individuals were classified with CMD. Among these, 28.27% (67) had periodontitis. Association measurements showed that the occurrence of periodontitis among those exposed to CMD is approximately 50% higher than in those without this mental condition, with statistical significance, after adjustment for age, sex, family income, current smoking habit, alcohol beverage consumption, and cardiovascular disease (PRadjusted  = 1.54, 95% CI: [1.13 to 2.10]). CONCLUSIONS: The findings showed a positive association between exposure to CMD and periodontitis, revealing the importance of broadening public actions targeting mental health, which seems to be related to oral health, mainly due to the high frequency of the diseases in the studied sample.

Is there association between stress and periodontitis?

OBJECTIVE: This study estimated the association between stress and periodontitis. MATERIALS AND METHODS: A cross-sectional study was conducted with a sample of 621 individuals. Information about individuals was obtained through a questionnaire. Stress was evaluated using the Perceived Stress Scale. The diagnosis of periodontitis was based on a complete periodontal examination including clinical attachment level, probing depth, and bleeding on probing. Prevalence ratios (PR), crude and adjusted, and their respective 95% confidence intervals (95%CI) were estimated by Poisson regression analysis. RESULTS: In the final sample, 48.47% (301) of the individuals were classified as having stress, of which, 23.92% (72) had the diagnosis of periodontitis. Association measurements between stress and probing depth ≥ 4 mm (PRadjusted = 1.28, 95%CI [1.04 to 1.58]), stress and clinical attachment level ≥ 5 mm (PRadjusted = 1.15, 95%CI [1.01 to 1.31]), and stress and periodontitis (PRadjusted = 1.36, 95%CI [1.01 to 1.83]) showed that the frequency of these outcomes among those exposed to stress was 15-36% higher than those without the condition of stress, after adjustment for age, sex, schooling level, current smoking habit, pulmonary disease, and body mass index. CONCLUSIONS: The findings showed positive association between exposure to stress and the presence of periodontitis, reaffirming the need to prevent and control stress. CLINICAL RELEVANCE: Although there are limitations in this study, the results showed that an association exists between stress and periodontitis, signaling the necessity of a multidisciplinary attention when considering the psychological status in the management of oral and general health conditions of the individual.

Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically analyze the relationship between maternal anemia and low birth weight. METHODS: A search of studies was conducted in the main databases (Medline, Embase, Scopus, Web of Science, SciELO, and Lilacs), the gray literature, and the reference lists of selected articles. Cohort and case-control studies that met the eligibility criteria were included in the review. There was no limitation on the language or date of publication. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects, subgroup analyses and meta-regressions were performed. Publication bias was measured using Egger regression and visual funnel plot inspection. RESULTS: A total of 7243 articles were found, of which 71 comprised the systematic review and 68 were included in the meta-analyses. Maternal anemia was associated with low birth weight with an adjusted OR: 1.23 (95% CI: 1.06⁻1.43) and I²: 58%. The meta-regressions confirmed that the sample size and the methodological quality may partially explain the statistical heterogeneity. CONCLUSIONS: Maternal anemia was considered a risk factor for low birth weight.

Association between osteoporosis treatment and severe periodontitis in postmenopausal women.

OBJECTIVE: To estimate the association between osteoporosis treatment and severe periodontitis in postmenopausal women. METHODS: This cross-sectional study comprised of 492 postmenopausal women, 113 women in osteoporosis treatment, and 379 not treated. Osteoporosis treatment consisted of systemic estrogen alone, or estrogen plus progestin, and calcium and vitamin D supplements, for at least 6 months. Severe periodontitis was defined as at least two interproximal tooth sites with clinical attachment loss of at least 6 mm, and at least one interproximal site with probing depth of at least 5 mm; and dental caries experience was measured using the decayed, missing, and filled teeth (DMFT) index. Analysis included descriptive statistics and Poisson multivariate analysis with robust variance. RESULTS: Women receiving osteoporosis treatment had less periodontal probing depth, less clinical attachment loss, and less gingival bleeding than women not receiving treatment for osteoporosis (P ≤ 0.05). In the osteoporosis treatment group, the estimated mean DMFT index score was approximately 20, the most frequent component being the number of missing teeth, and in the nontreated group, the DMFT index was approximately 19. The prevalence of severe periodontitis was 44% lower in the osteoporosis treatment group than in the nontreatment group. The prevalence ratioadjusted was 0.56, 95% confidence interval was 0.31 to 0.99 (P = 0.05), after adjustments for smoking, age, family income, and visit to the dentist. CONCLUSIONS: The results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment.

Relationship Among Mothers' Glycemic Level, Periodontitis, and Birth Weight.

BACKGROUND: The aim of this study is to determine the influence of glycemic level on the relationship between periodontitis and low birth weight (LBW). METHODS: A case-control study was conducted with 372 females divided into cases (109 mothers of newborns with birth weight < 2,500 g) and controls (263 mothers of newborns with birth weight ≥ 2,500 g). The birth weight of children was obtained from medical records, whereas information on sociodemographic, lifestyle, and health characteristics of the participants was obtained through an interview. Glycated hemoglobin (HbA1c) levels were measured, and probing depth, clinical attachment levels, and bleeding on probing were used to determine the periodontal status. Results were analyzed using logistic regression. RESULTS: The likelihood of having children with LBW among the mothers with periodontitis was six times greater than that observed among mothers without periodontitis (adjusted odds ratio [OR adjusted] = 6.02, 95% confidence interval [CI] = 2.47 to 15.17), even after adjustment. There was also a strong, statistically significant relationship between periodontitis and LBW in both the normal glycemic-level group (HbA1c levels < 5.6%, unadjusted odds ratio [OR unadjusted] = 8.30, 95% CI = 3.56 to 19.35) and the high glycemic-level group (HbA1c levels ≥ 5.6% and < 6.5%, OR unadjusted = 5.73, 95% CI = 1.75 to 18.70). After adjustment for confounders, the magnitude of the association continued to be strong in the normal glycemic-level group (OR adjusted = 7.59, 95% CI = 2.7 to 24.28), an increase of 25% when compared to the main association measurement. In those with high glycemic levels (OR adjusted = 4.03, 95% CI = 0.81 to 19.96), the OR decreased almost 50%, and the association lost statistical significance. CONCLUSION: Periodontitis and glycemic levels appeared to have opposing influences on birth weight, with periodontitis being associated with LBW and the magnitude of the association being altered depending on maternal blood glucose level.

Effect of osteoporosis on periodontal therapy among post-menopausal women.

OBJECTIVE: This intervention study aimed to investigate the effect of osteoporosis on periodontal condition among 48 post-menopausal women undergoing periodontal therapy. MATERIAL AND METHODS: The experimental group, which underwent non-surgical periodontal therapy, was composed of 16 women with periodontitis to be treated, and the control group was formed by 32 women without periodontitis. Oral condition was assessed on three occasions: at the start of the treatment (first examination), 1 month (first re-examination) and 4 months after the end of the therapy (second re-examination). In the second re-examination, recurrence of periodontal disease was evaluated by comparing the clinical measurements obtained pre- and post-treatment. The diagnosis of osteoporosis was made by investigating densitometry reports obtained previously. Descriptive analysis, analysis of variance and the Bonferroni post hoc test were applied to the data gathered, with statistical significance level of 5%. RESULTS: The frequency of periodontitis was 50% in the treated group and 25% in the group without periodontitis. In both groups, this recurrence was greater in subjects with osteoporosis (37.5 and 18.75%, respectively) than in the individuals without osteoporosis (12.5 and 6.25%, respectively). CONCLUSIONS: The preliminary results indicate that osteoporosis possibly has an influence on periodontal condition among individuals undergoing non-surgical periodontal treatment.

Periodontal therapy and low birth weight: preliminary results from an alternative methodologic strategy.

BACKGROUND: The purpose of this study is to present the use of a non-randomized experimental design with multiple controls, with emphasis on a historical control group, as an alternative methodologic resource for studies on the association between periodontal disease and prematurity/low birth weight. METHODS: The sample consisted of 234 pregnant women: 54 in the Test Group (treatment of periodontal disease); 68 in Control Group I (without periodontal disease); and 112 in Control Group II (historical control group, with untreated periodontal disease). The diagnosis of periodontal disease was established by means of a complete clinical examination, using measurements of probing depth, gingival recession, clinical attachment loss, and bleeding index. The women in the Test Group were treated for periodontitis and followed-up with periodontal support therapy throughout their pregnancies. After delivery, they were reevaluated regarding their periodontal condition, and information on the newborn's birth weight was obtained. This was also done for Control Groups I and II. Descriptive analyses on the study variables were performed using the χ(2) and Fisher exact tests. Association measurements (relative risk) were obtained using a significance level of 5%. RESULTS: The frequency of low birth weight among the Test Group was similar to Control Group I and lower than Control Group II. CONCLUSION: The results suggest that successful periodontal therapy in pregnant women suffering from periodontitis is a protective factor promoting the birth of children with normal weight.

Periodontal therapy for pregnant women and cases of low birthweight: an intervention study.

BACKGROUND: Over the past decade, strong evidence for an association between maternal periodontitis and low birthweight has started to appear. However, few intervention studies have been proposed for investigating this hypothesis. The aim of this study was to evaluate whether periodontal therapy among pregnant women would reduce the incidence of low birthweight. METHODS: A nonrandomized intervention study was performed, with two control groups. The sample comprised 339 pregnant women: 141 in the experimental group (treated for periodontitis), 145 in control group 1 (without periodontitis) and 53 in control group 2 (with untreated periodontitis). The experimental group received periodontal treatment throughout pregnancy, whereas control group 1 was only monitored over the same period. After delivery, birthweight information on the newborns was obtained. The analysis procedures consisted of stratified analysis followed by logistic regression. RESULTS: The frequency of low birthweight among the women with treated periodontitis was 9.22%, while it was 13.10% in the group without periodontal disease. However, the difference was not statistically significant (RR 0.72; 95% CI 0.36-1.45). The occurrence of this outcome in the group with untreated periodontitis (24.53%) was greater than in the other two groups. CONCLUSION: This suggests that periodontal therapy is a protective factor for birthweight.

Contribution of periodontal disease in pregnant women as a risk factor for low birth weight.

UNLABELLED: Starting in the 1990s, several authors sought to investigate the hypothesis that periodontitis during pregnancy may contribute towards the birth of low-weight children. However, this relationship is still not well established. The aim of this study was to evaluate whether this oral infection is associated with this gestational event. METHODS: This was a case-control study among 548 puerperae, of whom 164 were the mothers of low-weight live births (case group) and 384 were the mothers of live births of normal gestational weight (control group). They were selected at two public hospital units in two municipalities in the State of Bahia. From interviews and data gathered using live birth cards or birth certificates, information was obtained regarding age, height, previous diseases, marital status, socioeconomic situation, smoking and alcohol use. Mothers who presented at least four teeth on which one or more sites had a probing depth of greater than or equal to 4 mm, clinical attachment loss of greater than or equal to 3 mm and bleeding on probing, at the same site, were deemed to present periodontal disease. The data were analysed by stratification from logistic regression. RESULTS: Periodontal disease was diagnosed in 42.7% of the case group and 30% of the control group. A statistically significant association was found between periodontal disease and low birth weight (unadjusted OR = 1.74; 95% CI: 1.19-2.54), particularly among mothers with low schooling levels (adjusted OR = 2.30; 95% CI: 1.14-4.6). CONCLUSION: The findings suggest an association between periodontal disease and low birth weight among mothers with low education levels.

Periodontitis and nosocomial lower respiratory tract infection: preliminary findings.

AIM: To evaluate the possible association between periodontitis and nosocomial lower respiratory tract infection (LRTI). MATERIAL AND METHODS: A case-control study was conducted at a General Hospital in Feira de Santana, Bahia, Brazil. The sample consisted of 103 individuals: 22 cases (presence of nosocomial LRTI) and 81 controls (absence of nosocomial LRTI). The diagnosis of periodontitis was based on probing depth, gingival recession, clinical attachment loss and bleeding on probing. The diagnosis of nosocomial LRTI was made in accordance with established medical criteria. RESULTS: Invasive ventilation was much more frequent in cases (95.5%) than in controls (7.4%). An orotracheal tube was used in 81.8% of cases and in 7.4% of controls; bronchoaspiration was suspected in 81.8% of cases and in 6.2% of controls. There was no statistically significant difference in any of the clinical periodontal parameters between cases and controls. The crude odds ratio (OR) value for individuals with periodontitis having LRTI was not statistically significant [OR(crude)=1.70; 95% confidence interval:(0.60-4.87)]. After including age, smoking and duration of hospitalization in the logistic regression, the adjusted OR for individuals with periodontitis having LRTI was statistically significant [OR(adjusted)=3.67 (1.01-13.53); p=0.049]. CONCLUSIONS: A marginal association between periodontitis and LRTI was found when smoking, age and length of hospitalization were included as covariates. Patients with LRTI had a high frequency of suspected bronchoaspiration and this could explain the possible association of periodontal disease and LRTI found in this and other studies. Additional studies are needed to further clarify the possible relationship between periodontal disease and LRTI.

Fatores associados ao histórico de prática de atividade física em gestantes / Factors associated with a history of practicing physical activity among pregnant women

A necessidade do conhecimento dos fatores externos que podem influenciar na causalidade de eventos deletérios à gestação é de grande relevância, pois podem determinar a morbi-mortalidade infantil. Sabe-se que a prática de atividade física orientada, ao contrário, executada durante a gestação, traz benefícios. O objetivo deste estudo foi avaliar descritivamente os aspectos sociodemográficos, de saúde, estilo de vida em gestantes com histórico de prática de atividade física (PAF). Um estudo exploratório do tipo corte transversal foi composto por 164 grávidas, divididas em dois grupos: o GRUPO 01, de mulheres com histórico de prática de atividade física, e o GRUPO 02, de mulheres sem histórico de prática de atividade física. Todas responderam a um questionário para coletar dados sociodemográficos e de estilo de vida, além de informações acerca do histórico de prática de atividade física. Inicialmente, foram estimadas as freqüências das variáveis estudadas e então obtidas as medidas de associação (RP e IC 95%) entre o histórico de PAF e as variáveis em questão. Os resultados demonstraram uma precariedade no acesso aos serviços básicos de saúde, renda e escolaridade baixas, e a falta de prática de atividade física regular antes e durante a gestação.

Exposure measurement in the association between periodontal disease and prematurity/low birth weight.

AIM: To compare the use of different definitions for exposure measurement in cases of association between periodontal disease (PD) and prematurity and/or low birth weight (PLBW). MATERIAL AND METHODS: A database from a previous case-control study was used to compare four different definitions for periodontitis: at least one site with probing depth > or =4 mm (1); at least one site with clinical attachment loss (CAL)> or =3 mm (2); at least four teeth with one or more sites presenting probing depth > or =4 mm, with CAL> or =3 mm at the same site (3); and at least four teeth with one or more sites with probing depth > or =4 mm, with CAL> or =3 mm at the same site and presence of bleeding on probing (4). The PD frequency, diagnostic values and adjusted association measurements were calculated. RESULTS: PD frequency ranged from 33.1% to 94.7%. Odds ratio(adjusted) varied slightly according to the exposure measurement used. CONCLUSIONS: The association between PD and PLBW weight was consistent, except for exposure measurement 1, i.e. using at least one site with CAL> or =3 mm for periodontitis diagnosis, while the magnitude of this varied according to the definition established.

The association between postmenopausal osteoporosis and periodontal disease.

BACKGROUND: The clinical importance of systemic bone loss as a contributory factor to alveolar bone loss and the subsequent loss of teeth merits further study, given that osteoporosis and periodontal disease lead to significantly increased morbidity and mortality and higher public expenditure of funds. This case-control study evaluated the association between osteoporosis and periodontal disease. METHODS: The sample consisted of 139 postmenopausal women: 48 in the case group (with periodontal disease) and 91 in the control group (without periodontal disease). The diagnosis of periodontal disease was established following a complete clinical examination using measurements of probing depth, gingival recession and hyperplasia, clinical attachment loss, and bleeding index, and confirmed by panoramic radiography. The diagnosis of osteoporosis was made by reviewing densitometry reports obtained previously. Descriptive, stratified, and logistic regression analyses were applied to the data collected. Comparison of proportions was performed using the chi(2) and Fisher tests. Association measurements (odds ratios [ORs]) with and without adjustment for confounding factors and control for effect modifiers were obtained at a significance level of 5%. RESULTS: The OR(unadjusted) for the principal association was 2.58 (95% confidence interval [CI]: 1.01 to 6.82). In subgroup analyses of the stratified model, the OR(unadjusted) for low education was 6.40 (95% CI: 1.77 to 23.18). When adjusted for smoking habit and age, the OR(adjusted) was 7.05 (95% CI: 1.90 to 26.19), which also was statistically significant. CONCLUSION: Postmenopausal women with osteoporosis and low educational levels have a greater chance of having periodontal disease than do those without osteoporosis.