Maternal oral health and birth weight of twins

Objective: Oral health has been implicated in low birth weight or preterm birth. However, this relationship has not been studied in twins. We examined whether maternal oral health was associated with birth weight in twins. Methods: Utilizing Proc Mixed, Generalized Estimating Equation (GEE) to recognize the correlation between twins from the same mothers and independence between different mothers, 40 birth weights of twins were modeled as an outcome. In model 1, at least 1 or more maternal periodontal pockets deeper than >= 4 mm (Perio) were fitted as the main explanatory variable. In model 2, non-specific oral mucositis (NSOM) was fitted as a main predictor because we hypothesized that open sores in the oral mucosa might act as portals for inflammatory mediators such as cytokines and TNF-á involved in adverse birth outcomes. Adjusted covariates were gestational age at birth, maternal diabetes, and maternal smoking. Results: Babies from mothers with at least one deep periodontal pockets >= 4 mm (N=18) weighed approximately 183 gm less than babies of mothers without deep pockets. However, this association was not statistically significant (p = 0.11). For each day of gestation, babies gained 23 gm on average (p <.0001): babies from diabetic mothers weighed 540 gm more than those of non-diabetic mothers (p=0.007): babies of current smokers weighed165 gm less than non-smokers or past smokers combined although this was not significant (p = 0.18). In model 2, Mothers with NSOM had babies weighing 224.9 gm less than mothers without these lesions and this was nearly significant (p=0.08). These results are presented in Table 1 and Table 2. Conclusion: Although not significant, the results from this small sample of twins suggest that maternal oral health may be associated with birth weight of twin neonates. Our results may be appropriate for hypothesis generation for future studies.