二孩政策下不同胎次孕妇口腔健康相关生活质量的比较研究

Oral Health-Related Quality of Life of Pregnant Women with Different Parities Under the Two-Child Policy:A Comparative Study

目的分析二孩政策开放后一胎、二胎孕妇口腔健康相关生活质量(OHRQoL)的不同,探索其影响因素,为后期采取针对性口腔健康指导及干预措施提供参考依据。方法采用方便抽样法选取2018年12月至2019年12月西南医科大学附属医院和西南医科大学附属中医医院的一胎孕妇348名、二胎孕妇326名作为研究对象,采用一般资料调查表、孕期口腔保健知识问卷、牙科焦虑量表(DAS)、口腔健康素养量表(HeLD-14)以及口腔健康影响程度量表(OHIP-14)进行调查。比较一胎、二胎孕妇OHIP-14得分,并探索其影响因素。结果1)孕妇的OHIP-14得分为(28.54±7.76)分,其中一胎孕妇OHIP-14得分低于二胎孕妇,差异有统计学意义(P<0.001);2)一胎孕妇的口腔保健知识得分低于二胎孕妇(P<0.05),而DAS和HeLD-14得分高于二胎孕妇(P<0.05);3)多因素分析结果显示,一胎、二胎孕妇的OHIP-14得分均受文化程度、是否接受口腔保健指导、自评口腔卫生状况、牙科焦虑水平因素的影响,此外一胎孕妇还受居住地、职业状况、HeLD-14得分的影响,二胎孕妇受家庭收入、口腔保健知识得分的影响。结论二胎孕妇比一胎孕妇的OHRQoL低,应针对相关影响因素有计划地开展孕期口腔的多学科专业指导和健康促进活动,增强孕妇口腔保健意识,改善OHRQoL。

Objective To analyze the differences in oral health-related quality of life(OHRQoL)between first-child pregnant women and second-child pregnant women after the implementation of the two-child policy,and explore its influencing factors,so as to provide reference for later targeted oral health guidance and intervention measures.Methods Three hundred and forty-eight first-child pregnant women and 326 second-child pregnant women were selected from the Affiliated Hospital of Southwest Medical University and the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from December 2018 to December 2019 by convenient sampling method.General information questionnaire,oral health knowledge questionnaire during pregnancy,dental anxiety scale(DAS),health literacy in dentistry-14(HeLD-14),and oral health impact profile questionnaire(OHIP-14)were used for the investigation.The differences in OHIP-14 scores between the first-child and second-child pregnant women were compared,and the influencing factors were explored.Results The OHIP-14 score of pregnant women was 28.54±7.76,with that of first-child pregnant women significantly lower than that of second-child pregnant women(P<0.001).Compared with second-child pregnant women,first-child pregnant women scored significantly lower in oral health knowledge(P<0.05),but significantly higher in DAS and HeLD-14(P<0.05).Multivariate analysis results showed that the OHIP-14 scores of first-child and second-child pregnant women were generally affected by factors such as education,whether they received oral health care guidance,self-assessment of oral hygiene,and dental anxiety.Besides,OHIP-14 scores of first-child pregnant women were also affected by residence,occupational status,and HeLD-14 scores,while that of second-child pregnant women were also affected by family income and oral health knowledge scores.Conclusion The OHRQoL score of second-child pregnant women is lower than that of first-child pregnant women.Multidisciplinary professional guidance and health promotion activities for the oral cavity during pregnancy should be carried out according to relevant influencing factors to enhance the awareness of oral health care of pregnant women,help them develop good oral health care behavior,and improve OHRQoL.