不良妊娠结局即自然流产、早产(妊娠<37周)、胎死宫内、异位妊娠、葡萄胎、出生缺陷和低出生体重等,对人类的生殖健康影响严重,至今仍是全球性公共卫生问题[9]。 不良妊娠结局的发生是多种因素联合作用造成的,传统的危险因素包括孕妇年龄(<20岁、>35岁)、肥胖、双(多)胎妊娠、不良生活习惯、药物、妊娠期感染史、妊娠合并症和并发症等[10-13]。本研究所纳入的542例孕妇均为单胎妊娠,共分娩新生儿542例,无围产儿死亡事件发生,并且排除了既往有早产史、围产儿死亡史、阴道难产史、有严重的妊高症、糖尿病、贫血等妊娠合并症以及泌尿生殖道感染等其他常见危险因素。 本研究结果发现,牙科焦虑程度较高组孕妇出生早产儿、低出生体重儿、1分钟Apgar评分≤7分的发生率均高于牙科焦虑程度较低组,组间差异均有统计学意义(P<0.05),这提示DA对新生儿出生健康产生了不利影响,分析其原因可能是DA通过影响母亲的口腔健康状况而间接危害到胎儿健康。因此必须重视孕妇DA的防治,以提高孕前及孕期牙病患者的就诊率,为孕妇口腔保健服务提供帮助,进而减少口腔疾病引起的不良妊娠结局,为我国的优生优育工作作出一定的贡献。 [参考文献] [1] McGrath C,Bedi R.The association between dental anxiety and oral health-related quality of life in Britain[J].Community Dent Oral Epidemiol,2004,32(1):67-72. [2] Kumar S,Bhargav P,Patel A,et al.Does dental anxiety influence oral health-related quality of life? Observations from a cross-sectional study among adults in Udaipur district,India[J].J Oral Sci,2009,51(2):245-254. [3] Coolidge T,Hillstead MB,Farjo N,et al.Additional psychometric data for the Spanish Modified Dental Anxiety Scale,and psychometric data for a Spanish version of the Revised Dental Beliefs Survey[J].BMC Oral Health,2010,10:12. [4] 温艳丽,刘蕾,何爱民,等.孕妇牙科焦虑症相关因素分析[J].临床口腔医学杂志,2011,4(27):213-215. [5] Silk H,Douglass AB,Douglass JM,et al.Oral health during pregnancy[J].Am Fam Physician,2008,77(8):1139-1144. [6] Humphris GM,Dyer TA,Robinson PG.The modified dental anxiety scale:UK general public population norms in 2008 with further psychometrics and effects of age[J].BMC Oral Health,2009,9:20. [7] 张妮,周霞.重庆地区231名妊娠期妇女口腔健康状况及保健行为分析[J].现代医药卫生,2012,28(21):3230-3231. [8] 赵利芬,李承文,段开文.牙周病与不良妊娠结局关系的研究[J].国际妇产科学杂志,2009,36(2):144-147. [9] Bale JR,Stoll BJ,Lucas AO.Improving Birth Outcomes:Meeting the Challenge in the Developing World [M].Washington(DC):National Academies Press(US),2003:17-33. [10] 郭志荣,沈惠,周永兰,等.孕妇年龄与妊娠结局关系的流行病学研究[J].中国公共卫生学报,1997,16(1):20. [11] 季静敏,徐飚,陈梦如,等.649例低出生体重儿危险因素分析[J].中国妇幼保健,2008,23(32):4581-4583. [12] Wahabi HA,Fayed AA,Alzeidan RA,et al.The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes[J].BMC Endocr Disord,2014,14:47. [13] 张特,魏银花.老年拔牙患者牙科焦虑症的评估[J].中国当代医药,2012,19(10):42-43. |