孕期口腔健康行为与妊娠期糖尿病关系的病例对照研究

Case-control study on the relationship between oral health behavior during pregnancy and gestational diabetes mellitus

目的探究孕期口腔健康行为对妊娠期糖尿病(GDM)的影响。方法将2022年1月至12月在西北妇女儿童医院产科进行孕期血糖监测的146例GDM孕妇纳入病例组,634例健康孕妇纳入对照组。收集研究对象的一般人口学特征、孕期生活行为、妊娠相关信息、孕期口腔健康行为等相关资料;通过口腔健康影响程度量表-14(OHIP-14)评估孕妇的口腔健康相关生活质量;采用多元回归模型分析影响GDM发生的孕期口腔健康行为。结果病例组的饭后经常漱口、很少刷牙后进食、使用牙线、口腔不适时按时就诊、刷牙次数≥2次/d、刷牙时间≥3 min/次占比低于对照组(P<0.05)。病例组的疼痛与不适、功能受限、独立能力减弱评分及总分高于对照组(P<0.05)。多元回归分析结果显示,饭后很少漱口、经常或偶尔刷牙后进食、口腔不适时未按时就诊、高OHIP-14评分会增加GDM的发生风险,使用牙线会降低GDM的发生风险(P<0.05)。结论孕期口腔健康行为不良可能增加GDM的发生风险,应积极开展妊娠期口腔健康促进活动,改善口腔健康相关生活质量,促进母婴健康。

Objective To explore the effect of oral health behavior during pregnancy on gestational diabetes mellitus(GDM).Methods A total of 146 pregnant women with GDM who underwent gestational blood glucose monitoring in the obstetrics department of Northwest Women's and Children's Hospital from January to December 2022 were included in case group,and 634 healthy pregnant women were included in control group.The general demographic characteristics,life behavior during pregnancy,pregnancy-related information,oral health behavior during pregnancy and other related data of the objects were collected;Oral Health Impact Profile-14(OHIP-14)was used to assess the oral health-related quality of life of pregnant women;multiple regression model was used to analyze the oral health behavior during pregnancy that affected the occurrence of GDM.Results The proportions of frequent mouthwash after meals,rarely eating after brushing teeth,using dental floss,seeking timely medical attention for oral discomfort,brushing times≥2 times/d,brushing time≥3 min/time in the case group were lower than those in the control group(P<0.05).The pain and discomfort,functional limitation,decreased independent ability scores and total score in the case group were higher than those in the control group(P<0.05).The results of multiple regression analysis showed that seldom mouthwash after meals,frequent or occasional eating after brushing teeth,failed to seek timely medical attention for oral discomfort,and high OHIP-14 score increased the risk of GDM,while using dental floss reduced the risk of GDM(P<0.05).Conclusion Poor oral health behavior during pregnancy may increase the risk of GDM.Oral health promotion activities during pregnancy should be actively carried out to improve oral health-related quality of life and promote maternal and child health.