Prenatal care, oral health and birth outcomes: 2 year results

The 2000 U.S. Surgeon General's Report on Oral Health noted that preterm birth (PTB) and low birthweight (LBW) deliveries are considered the leading perinatal problems in the US. Many rural counties in Kentucky continue to demonstrate metrics of poor oral health and increased incidence of adverse pregnancy outcomes. Statewide there has been a 24% increase in the rate of PTB and a 22% increase in LBW babies since 1993, ranking it high nationally in these negative health measures. Recent epidemiologic data have suggested a relationship between the incidence of PTB/LBW pregnancies and the oral health of the expectant mother during gestation. Objective: This study evaluated the effect of a new prenatal/oral health care model, Centering Pregnancy with Smiles™, on birth outcomes in rural Kentucky. Methods: The model uses the CenteringPregnancy® method of providing group prenatal care to women at a similar gestational age (GA). In addition, Centering Pregnancy with Smiles™ provides oral health care to the expectant mothers to eliminate oral infections. All expectant mothers received a dental exam, complete debridement (12-16 weeks GA), treatment for any odontogenic infections, and a follow-up dental examination (34-38 weeks GA) to verify that no oral infections had reoccurred. 500 expectant mothers are enrolled in the study. At this time, 273 of the study mothers have delivered babies. Results: The results indicate that 19/273 births were PTB (6.96%). This was less than the 2004 PTB rate in Kentucky (15.8%) (Fisher Exact Test, p<0.01). 15/273 deliveries were identified as LBW (5.49%), which is significantly fewer LBW outcomes for Kentucky (8.5%, p<0.01) or for the targeted rural counties (9.6%) (p<0.01). Conclusions: These results indicate that a group prenatal care method combined with treatment of oral infections appears to lead to a reduction in PTB and LBW infants in historically underserved populations. Supported by HRSA grant 1 D1ARH0565653-01-00.