Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.5
,
No
.2
,
Jun
e
2
016
, pp
. 17
0
~ 1
75
I
S
SN
: 225
2-8
8
0
6
1
70
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Peri
odontal Dis
e
as
e on P
r
egna
nt Women (Case Study: Pondok
Labu Village, South Jakarta, Indonesia)
Rikaw
a
ras
t
u
t
i, N
g
atemi,
Ni
t
a
No
via
n
i H
a
r
a
h
a
p
Department o
f
D
e
ntal Nursing, Health Poly
t
echnic Jakar
t
a I, Ministr
y
of Health
, I
ndonesia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
Ma
r 8, 2016
Rev
i
sed
Ap
r
28
, 20
16
Accepted
May 18, 2016
During preganancy
, women per
i
odicall
y
concer
n about ANC due to fetus
growth, but igno
re their own periodontal
h
ealth.
This research w
a
s conducted
to acknowledge
the
effect of
ag
e, ed
u
c
ational background, p
a
rity, bod
y
mass
index (BMI),
diabetes mellitu
s, sm
oking habit and
oral h
y
giene with
periodontal d
i
sease on pr
egnan
t
women.
Analy
t
ical observation
stud
y
with
cross sectional
design was conducted
to pregn
a
nt women in Pondok Labu
Villag
e
(
K
elurahan)
, South Jakarta. Purposiv
e sampling was performed
among 101 resp
ondents. Chi Square and logi
stic regression were used for the
analy
s
is. R
e
sults shown that periodont
al d
i
seas
e on pregnan
t
women were
73.2% (66.3% w
e
re calcu
l
us and
6.9%
were hav
i
n
g
periodontal po
cket of 4-5
m
m
)
. It is proven that ther
e
is re
lationship
between age, education
a
l
background, p
a
rity
, BMI, d
i
ab
etes
mellitus, and smoking habit to th
e
periodontal disease. On th
e oth
e
r hand
, oral h
y
giene h
i
ghly
affected th
e
periodontal disease on pregnant woman.
Poor o
r
al h
y
gien
e is th
e dominant
factor of p
e
riod
ontal disease on
pre
gnant women after b
e
ing
co
ntrolled
b
y
age (OR= 21
.33, p valu
e 0.005)
.
It is
advised
for
pregnant women
to improve
their knowledg
e on how to care for their oral h
y
giene prio
r to
and during
pregnancy
,
as w
e
ll as, go th
r
oug
h tre
a
tm
ents wi
t
h
dent
ists.
Keyword:
K
now
ledg
e
Oral
hy
gi
e
n
e
Periodontal disease
Pre
gna
nt
wom
a
n
Copyright ©
201
6 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
R
i
kawara
st
ut
i
,
Depa
rt
m
e
nt
of Dent
al
Nu
rsi
n
g
,
Heal
t
h
P
o
l
y
t
echni
c
Jaka
rt
a I
,
M
i
ni
st
ry
of
He
al
t
h
,
Jl.
W
i
j
a
yaku
suma Raya n
o
.
47
, Ciland
ak
, Jak
a
r
t
a
Selatan
,
In
don
esia.
Em
a
il: rik
a
warastu
ti@g
m
ail.c
o
m
1.
INTRODUCTION
Pre
gna
ncy
i
s
a chal
l
e
ngi
n
g
p
h
y
s
i
o
l
o
gi
cal
and em
ot
i
onal
expe
ri
ence
f
o
r
a wom
a
n. T
h
e
m
a
jori
t
y
o
f
pre
g
nant wom
e
n, for the sa
ke of
good
heal
th of t
h
e child
to be
born as
well as becaus
e
of m
a
terial benefits
gua
ra
nt
eed fo
r pre
g
nant
wom
e
n
by
wel
f
ar
e sy
st
em
,
scrup
u
l
ousl
y
at
t
e
nd s
c
hed
u
l
e
d
m
e
di
cal
exam
i
n
at
i
o
ns
[
1
]
.
Pre
gna
ncy
i
s
an im
port
a
nt
m
i
l
e
st
one i
n
the l
i
f
e-co
u
r
se
of a fem
a
l
e
wi
t
h
t
h
e d
u
al
fact
ors o
f
p
r
egna
ncy
affect
i
n
g
oral
heal
t
h
a
n
d
ora
l
heal
t
h
a
ffect
i
n
g
t
h
e
p
r
e
gna
ncy
o
u
t
c
om
e. Du
ri
n
g
pr
eg
na
ncy
,
h
o
rm
ones
al
t
e
r
im
m
unores
po
n
s
i
v
enes
s an
d i
n
fl
am
m
a
t
o
ry
respo
n
se m
e
di
at
ors. T
h
i
s
has
be
en re
po
rt
ed t
o
cause o
r
al
p
r
o
b
l
em
s,
p
r
im
arily g
i
n
g
i
v
itis and
p
e
riod
on
tal infection
[2
].
Pre
g
n
a
nt wo
m
e
n
are
vu
ln
erab
le t
o
commo
n
oral d
i
seases
suc
h
as peri
o
d
ont
al
di
sease a
nd
dent
al
cari
e
s;
i
f
oral
hy
gi
e
n
e i
s
not
wel
l
m
a
i
n
t
a
i
n
ed d
u
r
i
ng t
h
i
s
pe
ri
o
d
,
t
h
ere
are i
m
pl
i
cati
o
n
s
fo
r
oral
hy
gi
ene i
n
he
r su
bs
eque
nt
l
i
f
e [
3
]
.
Neve
rt
hel
e
ss
,
pre
g
nant
wom
e
n are m
o
re
fo
cuse
d
on
ant
e
nat
a
l
ca
re
of t
h
e
devel
opm
ent
o
f
her
fet
u
s t
h
an
t
h
ei
r
de
nt
al
hy
gi
e
n
e
an
d
peri
od
o
n
t
a
l
heal
t
h
c
o
ndi
t
i
on.
Periodo
n
titis is a ch
ron
i
c inflammato
ry d
i
sease o
f
t
h
e tissu
es th
at supp
ort th
e teeth
.
Period
on
tal
d
i
sease is a co
mm
o
n
o
r
al
in
fection
with
p
r
ev
alen
ce
rang
ing
fro
m
1
0
-
6
0
% an
d refers to
g
i
ng
iv
itis and
p
e
ri
o
don
titis [4
]. Ex
po
su
re t
o
risk
facto
r
s, su
ch
as
ag
e,
lo
w so
cio-econ
o
m
ic statu
s
,
p
oor edu
cation
,
HIV
in
fection
,
l
o
w d
e
n
t
al
care u
tilizatio
n
,
po
or oral
h
y
g
i
en
e level, sm
o
k
i
n
g
hab
it,
p
a
rity (i.e.
n
u
m
b
e
r
of ch
ild
ren
bo
r
n
) a
nd
psy
c
ho s
o
ci
al
st
ress
t
e
nd t
o
a
r
i
s
e i
n
cert
a
i
n
po
p
u
l
a
t
i
ons. T
h
ese
f
act
ors a
r
e m
o
re, or a
s
i
m
port
a
nt
, as
race and ethnicity [5]. A rece
nt study
of
pre
gna
nt wom
e
n in Brazil reveal
ed a 47% pre
v
alence of
pe
riodontal
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Peri
od
o
n
t
a
l
Di
sease o
n
Pre
g
n
ant
Wo
me
n
(
C
ase St
u
d
y:
P
o
n
dok
L
a
b
u
Vi
l
l
age, ...
.
(
R
i
k
aw
a
r
ast
u
t
i
)
17
1
d
i
sease, ind
i
catin
g
a stron
g
n
eed
for th
e in
itiatio
n
o
f
o
r
al care d
u
r
i
n
g early p
r
egn
a
ncy. Th
e p
r
ev
al
en
ce
of
peri
odontal disease (PD)
am
ong B
r
azilian low-ris
k
pre
gna
nt wom
e
n and its association with
so
ciod
em
o
g
r
aph
i
c f
act
o
r
s,
h
a
b
its and
or
al hyg
ien
e
sho
w
s
a h
i
gh pr
ev
alen
ce
o
f
p
e
r
i
odon
tal d
i
sease and
it is
associated
with gingi
v
al bleeding on
p
r
o
b
i
n
g, m
o
re adva
n
ced gest
at
i
o
nal
age an
d o
b
esi
t
y
. A pr
o
g
ram
of
ora
l
hygiene
s
h
ould be i
n
cluded in prenat
al ca
re for early pre
gna
ncy, es
pecia
lly fo
r l
o
w-in
co
me po
pu
lation
s
[6
].
Research
ed
matern
al p
e
riodo
n
t
al d
i
sease in
th
e m
a
tern
ity u
n
it of Ho
sp
ital d
a
s Clín
icas, Fed
e
ral
Un
i
v
ersity o
f
Pern
am
b
u
c
o
,
in
th
e city o
f
Recife, in
th
e no
rt
h
eastern
reg
i
on o
f
Brazil sh
owed
th
at p
e
riod
on
titis
i
s
an im
port
a
nt
ri
sk fact
o
r
fo
r
prem
at
uri
t
y
, inde
pe
nde
nt
o
f
ot
he
r fact
o
r
s.
To est
a
bl
i
s
h t
h
i
s
as a sci
e
nt
i
f
ic fact
,
we bel
i
e
ve t
h
a
t
rand
om
i
zed st
udi
es are
nee
d
ed, i
n
or
de
r t
o
have a
great
e
r
deg
r
ee
of ce
rt
ai
nt
y
i
n
ascert
a
i
n
i
n
g
th
e im
p
act o
f
treat
m
e
n
t
for
p
e
rio
d
o
n
titis du
ri
ng
p
r
eg
n
a
n
c
y, with
reg
a
rd
to red
u
c
i
n
g prem
at
u
r
ity [7
].
Gi
ve
n t
h
e i
m
pact
of pe
ri
o
d
o
n
t
al
di
sease of
p
r
eg
na
nt
wom
e
n t
o
t
h
e
baby
t
o
be
bo
r
n
, i
t
i
s
necessa
ry
t
o
know the
fact
ors ass
o
ciated
with
m
a
tern
al p
e
riod
on
tal d
i
sease. Th
erefor
e, th
e
p
r
esen
t st
u
dy ai
m
s
to
ob
tain
the
facto
r
s asso
ciated
with m
a
ter
n
al p
e
riodo
n
t
al d
i
sease in Po
ndo
k Labu
Villag
e
(Kelu
r
ah
an
)
, So
ut
h J
a
kart
a,
In
d
onesi
a.
2.
R
E
SEARC
H M
ETHOD
2.
1.
Data Co
llection
Th
e pop
u
l
ation
o
f
th
is research
is ev
ery p
r
eg
n
a
n
t
wo
m
a
n
in
Po
ndo
k
Lab
u
Villag
e
, Sou
t
h
Jakarta,
In
d
onesi
a a
nd
t
h
e sam
p
l
e
s are som
e
pregna
nt
wom
e
n w
h
o
vi
si
t
e
d t
h
e he
al
t
h
cent
e
r (i
nt
egrat
e
d heal
t
h
cent
e
r
,
co
mm
u
n
ity h
ealth
cen
ter) in
Pon
dok
Lab
u
V
illag
e
. Th
e
data co
llectio
n
o
f
p
r
egn
a
n
t
wo
m
e
n
in
Pondo
k
Labu
Villag
e
h
a
s b
e
en
ap
prov
ed
by th
e Head
o
f
Pond
ok
Labu
Villag
e
. Th
e
sam
p
lin
g
u
s
ed pu
rp
osiv
e sam
p
l
i
n
g
m
e
thod on pre
gna
nt wom
e
n who unde
rtook routine
ante
natal care (ANC) st
arting
from
June to
Septe
m
ber
20
1
5
. T
h
e sam
p
l
e
s t
a
ke
n
wer
e
wom
e
n co
ns
i
s
t
e
nt
wi
t
h
t
h
e
i
n
cl
usi
o
n c
r
i
t
e
ri
a o
f
p
r
e
gna
nt
w
o
m
e
n age
d
≥
20
years o
l
d
,
who h
a
v
e
filled
out in
fo
rm
ed
co
nsen
t form
, wit
h
teeth
n
eed
ed fo
r m
easu
r
emen
t an
d
n
o
h
i
sto
r
y i
n
rad
i
ation
th
erap
y, m
ean
wh
ile, th
e ex
clu
s
ion
criteria ar
e p
r
eg
n
a
n
t
wo
m
e
n
ag
ed
<
2
0
years
o
l
d
and
u
n
willin
g
to
p
a
rticip
ate as t
h
e su
bj
ect
o
f
th
is research
.
Th
e m
i
n
i
m
u
m
q
u
a
n
tity of samp
le is 93
pregn
a
n
t
wo
m
e
n
,
bu
t for
th
is research
,
th
e
m
i
n
i
m
u
m
q
u
a
n
tity o
f
sam
p
le
tak
e
n
was 1
0
0
pregn
a
n
t
wo
m
e
n
.
After co
ndu
ctin
g th
e
researc
h
, t
h
e
r
e
were 1
04
pr
egna
nt
w
o
m
e
n, but
o
n
l
y
10
1 w
o
m
e
n wi
th com
p
l
e
t
e
i
n
t
e
rvi
e
w a
nd C
P
IT
N
exam
ination, t
h
ere
f
ore, these
101
pregna
nt
wom
e
n are
chosen as
data
sa
m
p
les.
The
researc
h
e
r
s di
d a
peri
odontal tissue e
x
a
m
ina
t
i
on wi
t
h
a m
a
xim
u
m
tim
e of
1
0
m
i
nut
es fo
r eac
h
responde
nt,
us
ing tools a
n
d
m
a
terial
s, such as,
de
ntal tweezer,
de
ntal
m
i
rror,
WH
O pe
riodontal
probe,
d
i
sclo
sing
so
lutio
n
an
d
alco
ho
l. Th
e resu
lts o
f
t
h
e ex
am
in
ation
are rec
o
rded
i
n
dental exam
ination
sheets
.
The
dat
a
c
h
ara
c
t
e
ri
st
i
c
of t
h
e
resp
o
nde
nt
s
w
e
re c
o
l
l
ect
ed
du
ri
n
g
in
terv
iews and
r
ecorded in
questionnaires.
2.
2.
Vari
ables
This resea
r
ch a
i
m
s
to obtain prevale
n
ce on pregna
n
t
wo
m
e
n
p
e
riod
on
tal disease an
d
its relatio
n
with
in
d
e
p
e
nd
en
t variab
les, su
ch
as, ag
e, edu
c
atio
n
a
l b
a
ckg
r
ou
nd
,
p
a
rity, bo
d
y
m
a
ss in
d
e
x
,
d
i
ab
etes m
e
llitu
s,
sm
oki
ng
ha
bi
t
and
de
nt
al
a
n
d
oral
hy
gi
e
n
e,
m
eanwhi
l
e
, t
h
e
de
pen
d
e
n
t
va
r
i
abl
e
i
s
pe
ri
o
d
ont
al
di
sease st
at
us.
Dent
al
an
d
ora
l
hy
gi
ene i
s
m
easure
d
wi
t
h
O
H
I
-
S sc
ore
,
w
h
i
c
h i
s
a com
p
o
s
i
t
e
i
ndex
bet
w
een De
b
r
i
s
In
de
x (D
I) a
n
d
C
a
l
c
ul
us In
de
x (C
I
)
. T
h
e O
H
I
-
S sco
r
e u
s
e
d
i
s
based
on
Gree
ne an
d Ve
rm
il
i
on cat
ego
r
i
e
s (0
.
0
– 1.
2
= g
o
o
d
;
1
.
3 – 3.
0
=
fai
r
;
3.
1 – 6.
0
= p
o
o
r).
The
peri
o
d
ont
al
t
i
ssue of t
h
e
pre
g
n
a
nt
w
o
m
e
n was exa
m
i
n
ed usi
ng C
P
IT
N sco
r
e a
n
d at
t
h
e sam
e
t
i
m
e
, i
t
was used t
o
pr
o
b
e t
h
e
peri
od
o
n
t
a
l
care nee
d
s
of
t
h
e
pre
g
nant
wom
e
n. T
h
e
WH
O
C
P
ITN
sco
r
es
are:
0
(h
ealth
y), 1
(bleed
in
g),
2
(calcu
lu
s), 3
(p
eri
o
don
tal p
o
c
k
e
t
≥
4-
5m
m
)
, and 4
(pe
r
i
o
d
ont
al
poc
ket
≥
6
mm)
.
C
P
ITN
sco
r
e
f
o
r
0 m
eans he
al
t
h
y
and t
h
ere
i
s
no
nee
d
f
o
r
any
t
r
eat
m
e
nt
, 1 i
n
t
e
r
p
ret
s
bl
eedi
n
g a
nd t
h
e
r
e i
s
a
req
u
i
r
em
ent
fo
r t
h
e
i
m
prove
m
e
nt
of
pe
rs
on
al
oral
hy
gi
e
n
e
,
2
i
n
t
e
r
p
ret
s
c
a
l
c
ul
us a
n
d t
h
e
r
e i
s
a
re
qui
r
e
m
e
nt
fo
r
scalin
g
an
d an i
m
p
r
ov
em
en
t in
oral h
y
g
i
en
e, 3
i
n
terp
rets
period
on
tal po
ck
et
≥
4
–
5 m
m
whi
c
h re
qui
res f
o
r
scal
i
ng a
nd a
n
im
pro
v
em
ent
in o
r
al
hy
gi
ene
and
4 i
n
t
e
rp
ret
s
peri
od
o
n
t
a
l
p
o
cket
≥
6 m
m
whic
h re
q
u
ires
fo
r a
m
o
re com
p
lex treatm
e
nt. The
peri
odontal disease status
o
f
t
h
e res
p
on
de
nt
i
s
det
e
rm
ined by a second cate
g
ory
fr
om
C
P
ITN s
c
ore;
n
o
n
P
D
(
P
eri
o
d
ont
al
Di
sease)
wi
t
h
C
P
ITN
sc
ore
o
f
0
–
1, a
n
d P
D
i
f
C
P
ITN
sc
ore
≥
2.
2.
3.
Da
ta
A
n
al
ysi
s
IBM
SPSS
Statistic
fo
r W
i
ndo
ws
(v
ersi
on
17
.0
) was u
s
ed
fo
r d
a
ta p
r
o
cessin
g
.
Th
e
ch
aracteristics
o
f
th
e resp
ond
en
t
s
were calcu
lated
using
d
e
scri
p
tiv
e statis
t
i
c
s, i
n
cl
udi
ng
fr
eq
uenci
e
s a
n
d pe
rcent
a
ges. B
i
v
a
ri
at
e
anal
y
s
i
s
was
c
o
n
d
u
ct
ed t
o
o
b
ser
v
e t
h
e
rel
a
t
i
ons
hi
p
bet
w
een eac
h i
nde
pen
d
e
n
t
v
a
ri
ab
l
e
(age
, e
duca
t
i
ona
l
b
ackgroun
d, parity, b
o
d
y
m
a
ss in
d
e
x
,
d
i
abetes
m
e
l
litu
s, sm
o
k
i
n
g
h
a
b
it an
d
d
e
n
t
al and
oral h
y
g
i
en
e) with
d
e
p
e
nd
en
t
v
a
r
i
ab
le (p
er
i
o
dontal d
i
sease statu
s
). Th
e b
i
v
a
r
i
ate an
alysis was con
d
u
c
ted
w
ith
a sim
p
le l
o
g
i
stic
regression
fo
r
v
a
riab
les with
measu
r
em
en
t resu
lt o
f
m
o
re than
2 categories and chi square, speci
fically for
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
5, No
. 2,
J
u
ne 2
0
1
6
:
17
0 – 1
7
5
17
2
varia
b
le
m
easurem
ent result of 2 categories.
Analysis was
conducted
to
i
d
en
tify p
v
a
lu
e
and ris
k
facto
r
s (o
dd
rat
i
o
)
o
f
eac
h i
nde
pe
nde
nt
var
i
abl
e
.
Th
e m
u
ltiv
ariate an
alysis co
n
d
u
c
ted
was l
o
g
i
stic
reg
r
essio
n
an
alysis. Th
e log
i
stic reg
r
essi
on
was
selected beca
use the
de
pende
n
t va
riable i
n
t
h
is res
ear
c
h
,
p
e
ri
o
d
o
n
t
a
l
di
se
ase st
at
us,
i
s
d
i
chot
om
ous
(P
D a
n
d
no
n PD
).
3.
R
E
SU
LTS AN
D ANA
LY
SIS
3.
1.
C
h
a
r
a
c
t
eris
t
ic of
P
r
eg
na
nt
W
o
men
ba
s
e
d o
n
Ag
e, Ed
u
c
a
t
io
na
l Ba
ckgro
u
nd
,
P
a
rity
The cha
r
act
eri
s
t
i
c
of t
h
e pre
gna
nt
w
o
m
e
n
base
d on a
g
e, educat
i
o
nal
ba
ckg
r
ou
n
d
and
pari
t
y
can be
o
b
s
erv
e
d in
Tab
l
e 1. Tab
l
e 1
sh
ows t
h
at th
e
q
u
a
n
tity o
f
p
r
eg
n
a
n
t
wo
m
e
n
≥
35
years o
l
d
w
e
r
e
lesser
(
25.7%)
whe
n
c
o
m
p
ared t
o
pre
g
n
a
nt
wom
e
n age
d
<
35 y
ear
s ol
d
(7
4.
3%
) beca
u
s
e pre
g
nant
w
o
m
e
n wh
o r
o
u
t
i
n
el
y
v
i
sited
h
e
alth
facilities (in
t
eg
rated
h
e
alth
p
o
s
t
,
co
mm
u
n
ity h
ealth
cen
t
e
r) i
n
Po
ndo
k Labu
Villag
e
wer
e
d
o
m
in
ated
b
y
yo
un
g
m
o
th
er
s.
Tabl
e1
. C
h
a
r
ac
t
e
ri
st
i
c
of
pr
eg
nant
w
o
m
e
n ba
sed
o
n
a
g
e, e
d
ucat
i
onal
bac
k
gr
o
u
n
d
a
n
d
par
i
t
y
Variable
Total
n %
Age
< 35 y
o
75
74.
3
≥
35 y
o
26
25.
7
Educational Background
L
o
w E
ducational
Backgr
ound
76
74.
3
High E
ducational Backgr
ound
25
25.
7
Pa
rity
0 -
1
66
65.
3
≥
2
35
34.
7
The m
a
jori
t
y
of t
h
e p
r
eg
na
n
t
wom
e
n had l
o
w e
d
ucat
i
ona
l
back
gr
o
u
n
d
(
e
l
e
m
e
nt
ary
school
t
o
hi
g
h
school)
for as
m
u
ch as 74.
3% and t
h
ose with a high educational
bac
k
ground
(academ
y or unive
r
sity) we
re
2
5
.7%. Mo
th
ers with
lo
w educatio
n
a
l
bac
k
g
r
o
u
nd p
r
ef
er t
o
go t
o
m
i
dwi
v
es
in
th
eir n
earest In
tegrated Health
Po
st
o
r
C
o
mm
u
n
ity Health
Cen
t
er
for their an
tena
tal care beca
use it
is n
ear and
cheape
r
, m
eanwhile,
p
r
egn
a
n
t
wo
men
with
h
i
gh
ed
u
cation
a
l b
a
ck
gro
und
h
a
v
e
m
o
re o
p
p
o
r
t
unities to
v
i
sit
th
e h
o
s
p
ital o
r
priv
at
e
clinic becaus
e
they can a
f
fo
rd it. The
r
e a
r
e
responde
nts
with c
h
ildre
n
and
ot
hers a
r
e
their first pre
gna
ncy.
Nu
llip
ara and
p
r
im
ip
ara p
r
egn
a
n
t
wo
m
e
n
were 6
5
.3% and
m
u
l
tip
ara wo
m
e
n
were
3
4
.7%. Su
ch
d
a
ta in
dicates
a successful bi
rth c
o
ntrol
program
or
fam
i
l
y
with
quality in P
ondok Labu Village.
3.
2.
Cha
r
a
c
teristic o
f
Preg
na
nt
Wo
men ba
sed o
n
B
o
dy
Ma
ss Index
,
Dia
b
etes Mellitus, Smo
k
ing
Ha
bi
t
and
De
nt
al
a
n
d Or
al
H
ygi
en
e
The c
h
aract
eri
s
t
i
c
of p
r
e
gna
n
t
wom
e
n base
d o
n
bo
dy
m
a
ss i
nde
x,
di
abet
es
m
e
l
l
i
t
u
s, sm
oki
ng
ha
bi
t
and
de
nt
al
a
n
d
oral
hy
gi
e
n
e
ca
n be ob
ser
v
ed
i
n
Ta
bl
e 2.
Tabl
e 2.
C
h
ara
c
t
e
ri
st
i
c
of p
r
e
gna
nt
wom
e
n base
d on
b
o
d
y
m
a
ss
i
nde
x, di
abet
es
m
e
l
l
i
t
u
s,
sm
oki
n
g
habi
t
and
dent
al
a
n
d
o
r
al
hy
gi
e
n
e
Variable
Total
n %
BMI
<18.
5 6
5.
9
18.
5-
22.
9
25
24.
8
>=23 70
69.
3
Syte
m
i
c Disease
DM 2
2
Non DM
99
98
Sm
ok
i
n
g H
a
b
i
t
Non Sm
oker
2
2
Sm
oker 99
98
Dent
al
and O
r
al H
ygiene
0.
0 – 1.
2 (
good)
28
27.
7
1.
3 – 3.
0 (
f
air
)
56
55.
4
3.
1 – 6.
0 (
poor
)
17
16.
8
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Peri
od
o
n
t
a
l
Di
sease o
n
Pre
g
n
ant
Wo
me
n
(
C
ase St
u
d
y:
P
o
n
dok
L
a
b
u
Vi
l
l
age, ...
.
(
R
i
k
aw
a
r
ast
u
t
i
)
17
3
Tabl
e 2
descri
bes t
h
at
6
9
.
3
%
of p
r
e
gna
nt
w
o
m
a
n has B
M
I ove
r 2
3
w
h
i
c
h
can be cat
eg
o
r
i
zed as o
v
e
r
w
e
i
ght
.
Thi
s
i
s
com
m
on
beca
use p
r
egna
nt
w
o
m
e
n gai
n
wei
ght
.
Pre
gna
nt
w
o
m
e
n wi
t
h
i
n
de
x
< 18.
5 we
re
5.
9%
because they
were
in their first ti
m
e
ster. Respondents
with a
sm
oking
ha
bit we
re
2 and t
h
ere
we
re 2 with
di
abet
es m
e
ll
i
t
us. T
h
e O
H
I
-
S
i
ndex
of t
h
e
r
e
sp
on
de
nt
s wi
t
h
fai
r
dent
al
and
oral
hy
gi
en
e was 5
5
.
4
%,
wi
t
h
go
o
d
dent
al
a
n
d oral
hy
gi
e
n
e 27
.7
%
a
n
d
wi
t
h
po
o
r
dent
al
a
n
d
o
r
al
hy
gi
en
e
1
6
.
8
% res
p
o
nde
nt
s.
3.
3.
Peri
od
ont
a
l
D
i
sease and
De
nt
al
Care for
Pregnant
W
o
men
The
nee
d
f
o
r
d
e
nt
al
care
was
m
easured
usi
n
g C
P
ITN
sco
r
e
an
d ca
n be
o
b
s
erve
d i
n
Ta
bl
e 3.
Tabl
e
3
sh
ows t
h
at n
e
ed
fo
r
d
e
n
t
al care of pregnan
t
wo
m
e
n
in
Pon
dok
Labu Villag
e
, 21
.8% respon
d
e
n
t
s were
decl
are
d
heal
t
h
y
an
d di
d n
o
t
nee
d
any
t
r
eatm
e
nt
, 5%
of t
h
e
res
p
o
nde
nt
s we
re
bl
eedi
n
g a
nd
need
im
pro
v
em
ent
s
i
n
pers
onal
oral
hy
gi
ene,
66
.3
% of t
h
e
resp
on
de
nt
s had cal
cul
u
s
and
need scal
i
ng an
d
im
pro
v
em
ent
s
i
n
o
r
al
hy
gi
e
n
e
,
an
d
6
.
9%
of
t
h
e
resp
o
n
d
e
nt
s
ha
d
peri
od
o
n
t
a
l
p
o
cket
≥
4 – 5
m
m
and
sc
al
i
n
g
and
i
m
provem
e
nt
s i
n
o
r
al
h
y
g
i
e
ne a
r
e
ne
eded
. T
h
e
pe
ri
od
o
n
t
a
l
di
seas
e st
at
us
of
t
h
e
res
p
o
n
d
ent
s
c
a
n
be
obs
er
ved
i
n
Ta
bl
e 4
.
Tabl
e
3. C
P
IT
N sc
ore
o
f
t
h
e
pre
g
nant
w
o
m
e
n
CPITN Scor
e
Total
n %
0 (healthy)
22
21.
8
1 (
b
leeding)
5 5.
0
2 (calculus)
67
66.
3
3 (
p
er
iodontal pok
et
≥
4
-
5
mm)
7 6.
9
4 (
p
er
iodontal poc
ket
≥
6
mm)
0 0
Tabl
e 4. Peri
od
ont
al
di
sease
st
at
us of
t
h
e pre
gna
nt
wom
e
n
Variable
Total
n %
Periodontal Disea
s
e
Non PD
27
26.
8
PD
74
73.
2
Th
e
p
r
ev
alence of peridon
tal d
i
sease
of
p
r
eg
n
a
n
t
wo
m
e
n
in
Pon
dok
Lab
u
Villag
e
is 7
3
.2%.
Th
e
pre
v
al
ence
o
f
peri
od
o
n
t
a
l
di
sease of
p
r
eg
na
nt
w
o
m
e
n i
n
t
h
i
s
researc
h
i
s
h
i
gh
(7
3.
2%
) as
was f
o
un
d i
n
heal
t
h
-
care ce
nters i
n
the ce
ntral a
n
d eastern
re
gions
of Sa
udi
Arab
ia du
e t
o
li
mited
k
n
o
w
ledg
e an
d awareness on
peri
od
o
n
t
a
l
di
s
ease an
d i
t
s
e
f
f
ect
s o
n
pre
gna
ncy
am
ong
p
r
e
gna
nt
wom
e
n [
8
]
.
3.
4.
An
al
ysi
s
of
Re
l
a
ti
o
n
shi
p
Anal
y
s
i
s
of rel
a
t
i
ons
hi
p bet
w
een vari
a
b
l
e
s
o
f
age
,
e
ducat
i
o
nal
bac
k
gr
o
u
n
d
, pari
t
y
, bo
dy
m
a
ss
i
ndex,
di
abet
es m
e
ll
i
t
us, sm
oki
n
g
ha
bi
t
and
dent
al
and
oral
hy
gi
ene can
be o
b
se
rve
d
i
n
Ta
bl
e 5
.
Tabl
e 5 s
h
o
w
s t
h
ere
are no
sign
ifican
t relation
s
h
i
p
s
statistically
b
e
tween
ag
e,
ed
u
cation
a
l
b
a
ck
gro
und
,
p
a
ri
ty, b
o
d
y
m
a
ss in
d
e
x
,
d
i
ab
etes m
e
l
lit
u
s
and
sm
o
k
i
n
g
h
a
b
it with p
e
riod
on
tal disease,
m
ean
wh
ile, th
e v
a
riab
le with
sig
n
i
fican
t
rel
a
t
i
ons
hi
p
st
at
i
s
t
i
call
y
i
s
den
t
al
dan
o
r
al
hy
gi
ene
(
p
val
u
e
< 0.
0
5
)
.
Periodontal dis
ease is charact
erised
by
d
e
stru
ctio
n
of th
e
period
on
tal lig
amen
t, b
o
n
e
and
soft tissu
e as
a resu
lt
of a l
o
cal
h
o
st
im
m
une resp
o
n
se t
o
m
i
crobi
al
pl
aq
ue o
n
the to
o
t
h
surface. If left un
treat
ed
, th
is i
n
flammatio
n
l
eads t
o
al
veo
l
ar bo
ne res
o
r
p
t
i
on a
n
d
,
eve
n
t
u
al
l
y
, t
oot
h l
o
ss The se
ver
i
t
y
of t
h
e di
sease i
s
m
odi
fi
ed b
y
g
e
n
e
tics,
h
o
s
t
respon
se and
lifestyle facto
r
s su
ch
as
oral healthcare, sm
oking, age
,
race
, horm
onal change
s,
obe
sity, and
diabetes [9].
Fro
m
th
e resu
lt o
f
th
is
research
, it is con
c
lud
e
d
t
h
at poor
dental and
oral
hygiene ca
n i
n
crease t
h
e
r
i
sk
of
p
e
r
i
o
don
tal d
i
sease st
atu
s
. Th
e r
e
su
l
t
is in
acco
r
d
a
n
ce
w
ith
t
h
e
resear
ch co
nducted
in Br
azil
w
h
ich
concl
ude
d t
h
at
p
o
o
r
dent
al
a
n
d
oral
hy
gi
ene
i
s
rel
a
t
e
d t
o
pe
ri
o
d
o
n
t
a
l
di
sea
s
e wi
t
h
a
v
e
r
ag
e val
u
e
o
f
i
n
de
x
o
n
d
e
n
t
al p
l
aq
u
e
an
d
b
l
eed
i
n
g
o
n
p
r
o
b
i
n
g
w
a
s si
g
n
i
f
i
can
tly h
i
gh
er
in
p
e
r
i
o
dontal d
i
sease g
r
ou
p
[
6
]. Th
e r
e
su
lt o
f
th
e research
in Brazil is
in
a
cco
rd
an
ce with
th
e rese
arch
o
n
p
r
eg
nan
t
wo
m
e
n
in
An
ten
a
tal Clin
ic (
A
n
C
)
of
Lagos State Unive
r
sity Teaching Ho
s
p
ital (LASUT
H),
Ikeja, La
gos
w
hi
ch s
h
ows a si
gni
ficant relations
hi
p
bet
w
ee
n
peri
od
ont
al
di
sease st
at
us
wi
t
h
C
P
I a
n
d
O
H
I
-
S
sco
r
e va
ri
abl
e
s
[1
0
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
5, No
. 2,
J
u
ne 2
0
1
6
:
17
0 – 1
7
5
17
4
Table
5. T
h
e
re
lationshi
p
between the
charact
eristic
of the
re
sponde
n
ts and
peri
odontal dis
ease status
Variable
Per
i
odontal Disease Status
95%CI
P value
Non PD
PD
n %
N
%
Age
< 35 y
o
17
22.
7
58
77.
3
0.
180 – 1.
22
2
0.
190
≥
35
y
o
10
38.
5
16
61.
5
Educational Background
L
o
w
E
ducational
Backgr
ound
17
22.
4
59
77.
6
0.
165
–
1.
13
4
0.
142
High
E
ducational
Backgr
ound
10
40.
0
15
60.
0
P
a
r
i
t
y
0 – 1
20
30.
3
46
69.
7
0.
652 – 4.
63
7
0.
380
≥
2
7
20.
0
28
80.
8
BMI
<18.
5
1 16.
7
5 83.
3
0.
189
–
15.
8
2
3
1.
731
18.
5-
22.
9
8
32.
0
17
68.
0
0.
271
–
1.
99
3
0.
271
>=23
18
25.
7
52
74.
3
Syste
m
i
c
Disease
Non
DM
27
27.
3
72
72.
7
0.
645
–
0.
82
1
0.
955
DM
0 0 2
100
Sm
ok
i
n
g H
a
b
i
t
Non
Sm
oker
27
27.
3
72
72.
7
0.
645
–
0.
82
1
0.
955
Sm
oker
0 0 2
100
Dent
al
and O
r
al H
ygiene
0.
0 – 1.
2 (
good)
16
57.
1
12
42.
9
1.
3 – 3.
0 (
f
air
)
10
17.
9
46
82.
1
2.
225 -
16.
904
0.
005*
3.
1 – 6.
0 (
poor
)
27
26.
7
74
73.
3
2.
474 – 18
3.
965
0.
005*
The m
a
i
n
fact
or o
f
pe
ri
o
d
o
n
t
a
l
di
sease i
n
p
r
e
gna
nt
w
o
m
e
n can be
o
b
ser
v
e
d
i
n
Ta
bl
e 6. T
h
e
poor de
ntal and oral hy
giene
is the
m
a
in
factor of peri
odontal
disease
because the
risk of
suffering from
peri
od
o
n
t
a
l
di
sease i
s
21
.3
3 t
i
m
es hi
ghe
r (
p
val
u
e
0.
00
5) a
f
t
e
r bei
n
g co
nt
r
o
l
l
e
d by
t
h
e a
g
e vari
a
b
l
e
. The
po
o
r
d
e
n
t
al and
o
r
al
h
y
g
i
en
e can be tr
igg
e
r
e
d
b
y
t
h
e co
m
p
lex
physio
lo
g
i
cal alter
a
tio
n in pr
egnan
t
w
o
m
e
n
,
such
as,
nau
s
ea an
d v
o
m
i
t
i
ng, u
p
t
o
a
chan
ge i
n
di
et
and p
o
o
r
oral
hy
gi
ene
.
O
r
al
heal
t
h
d
u
ri
ng
p
r
eg
na
ncy
i
s
im
po
rt
ant
in
order t
o
m
i
n
i
m
i
ze p
o
ssib
l
e
u
n
d
e
sirab
l
e
p
e
rin
a
tal resu
lts
an
d to
im
p
r
ov
e th
e
q
u
a
lity of
life and
wellb
ein
g
o
f
t
h
e ex
pect
ant
m
o
t
h
er and
he
r
ba
by
. A
p
r
o
g
r
a
m
of
oral
hea
l
t
h
care s
h
o
u
l
d
be
devel
ope
d
and
i
m
pl
em
ent
e
d f
o
r
earl
y
p
r
eg
na
nc
y
an
d s
h
o
u
l
d
pr
o
v
i
d
e i
n
f
o
rm
at
i
on
o
n
oral
h
y
g
i
e
ne a
n
d
per
i
od
ont
al
t
r
eat
m
e
nt
d
u
ri
n
g
p
r
enat
al
care,
part
i
c
ul
a
r
l
y
am
ong
w
o
m
e
n at
great
er
ri
sk [
6
]
.
Whe
r
eas,
pre
g
nan
c
y
i
s
an im
po
rt
ant
m
i
l
e
st
on
e i
n
a
wo
m
a
n
’
s life an
d it sugg
ests fo
r an in
creased n
e
ed
fo
r dent
a
l
care,
am
on
g ot
he
r heal
t
h
car
e
nee
d
s [3]
.
Tabl
e 6.
M
a
i
n
fact
or
o
f
peri
o
d
o
n
t
a
l
di
seas
e i
n
p
r
e
gna
nt
wo
m
e
n
Variable
OR (
95%CI
)
P value
Age
2.
634 (
0
.
880 – 7.
8
85)
0.
083
Dent
al
and O
r
al H
ygiene
(
1
)
6.
752 (
2
.
357 – 1
9
.
340)
0.
000*
(2
)
23.
283 (
2
.
6
2
1
– 20
6.
834)
0.
005*
4.
CO
NCL
USI
O
N
Th
e prev
alen
ce in
p
e
ri
o
don
tal d
i
sease o
n
p
r
egn
a
n
t
wo
men
in
Po
ndo
k
Labu
Villag
e
is o
f
h
i
gh
and
si
gni
fi
ca
nt
l
y
r
e
l
a
t
e
d wi
t
h
de
nt
al
an
d
oral
hy
gi
ene
.
P
o
or
de
nt
al
an
d
o
r
al
hy
gi
ene i
s
t
h
e m
a
i
n
fac
t
or
of
peri
od
o
n
t
a
l
di
s
ease i
n
pre
g
na
nt
w
o
m
e
n aft
e
r
bei
n
g c
o
nt
rol
l
ed
by
age
va
ri
abl
e
. P
r
eg
na
nt
wom
e
n are a
d
v
i
sed t
o
i
m
p
r
ov
e th
e kn
owledg
e and sk
ill in
d
e
n
t
al an
d
o
r
al h
y
gien
e p
r
i
o
r to
an
d
d
u
ring
preg
n
a
n
c
y, go
th
rou
g
h
t
r
eatm
e
nt
s wi
th de
nt
i
s
t
s
and
enco
ura
g
e he
al
t
h
care st
aff t
o
gi
ve ed
ucat
i
on
on de
nt
al
and
oral
hy
gi
e
n
e fo
r
pre
g
nant
w
o
m
e
n.
ACKNOWLE
DGE
M
ENTS
We w
oul
d l
i
k
e t
o
t
h
an
k He
ad o
f
De
part
e
m
ent
of
De
ntal Nursi
n
g
,
He
alth
Polytechnic Jakarta I,
Min
i
stry of
Health
, for th
e sup
port of
t
h
is
research.
Infin
ite gratitu
d
e
aw
ard
e
d to pr
eg
n
a
nt w
o
m
e
n
in Pon
dok
Labu
Villag
e
(
K
el
urah
a
n
)
who
h
a
d
p
a
rticip
ated
in
th
e stu
d
y
. Th
e
research
was fu
nd
ed
b
y
th
e Health
Pol
y
t
echni
c
Ja
kart
a
I, M
i
ni
st
r
y
of
Heal
t
h
, t
h
e R
e
p
ubl
i
c
of
I
n
d
o
n
esi
a
,
2
0
1
5
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Peri
od
o
n
t
a
l
Di
sease o
n
Pre
g
n
ant
Wo
me
n
(
C
ase St
u
d
y:
P
o
n
dok
L
a
b
u
Vi
l
l
age, ...
.
(
R
i
k
aw
a
r
ast
u
t
i
)
17
5
REFERE
NC
ES
[1]
E. Gasz
y
ń
ska
,
et al.
, “
D
ent
a
l
a
w
arenes
s
and
o
r
al h
eal
th of
pr
egnant
wom
e
n i
n
P
o
land,
”
Int.
J. Occup. Med
.
Environ. Health
, vol/issue: 28(3)
, pp. 603–11, 201
5.
[2]
M. N. Wander
a
,
et al
., “Periodontal status,
tooth
lo
ss and self-repo
rted periodontal
pr
oblems effects on oral impacts
on daily
perform
ances, OIDP, in
pregnant wo
men in Uganda: a cr
oss-sectional stu
d
y
,”
Health Qual.
Life Outcom
es
,
vol. 7
,
pp
. 89–99
, 2009
.
[3]
N. Karunach
and
r
a,
et al.
, “Reply to comment on: oral health status
during pregnancy
:
rur
a
l-urb
a
n comparisons of
oral d
i
sease burd
e
n among
anten
a
tal women in Sri Lank
a,”
Rural Remote
Healt
h
, vol/issue: 12(3), pp.
2348
,
2012
.
[4]
X. Xiong,
et al.
, “Periodontal d
i
sease and
adverse pregna
n
c
y
o
u
tcomes: a s
y
s
t
ematic r
e
view,”
BJOG An Int
.
J.
Obs
t
et. Gyn
a
eco
l
, vo
l/issue: 113(
2), pp
. 135–143
, 2006.
[5]
M. Wandera,
et al.
, “Socio-dem
ographic f
actors
related to perio
dontal
status an
d tooth loss of pregnant women in
M
b
ale d
i
s
t
ric
t
,
Uganda,
”
BMC Oral Health
, vol/issue: 9(1), pp
. 18
–29, 2009
.
[6]
M. Vogt,
et al.
, “Factors associated with th
e p
r
evalence of pe
riodontal d
i
seas
e in low-risk pregnant women,”
Reprod. H
e
alth
,
vol/issue:
9(1), p
p
. 3–11
, 2012
.
[7]
M.
D.
B.
V Piscoy
a,
et al.
, “Maternal p
e
riodon
titis as a ri
sk f
a
cto
r
for prematur
ity,”
Pedia
t
r. Int
.
, vol/issue:
54(1)
,
pp. 68–75
, 2012
.
[8]
F.
A.
Asa’ad,
et al.
, “Periodontal disease awaren
ess among
pregnant
women in t
h
e centr
al and eastern regions of
Saudi Arabia.,”
J. In
ves
t
i
g.
Clin
.
Dent.
, vo
l/issue: 6(1), pp. 8–15,
2015.
[9]
B. P. Veselinovic,
et al.
, “Changes in inflammator
y
mediators in gi
ngival crev
icular fluid follo
w
ing periodontal
disease tre
a
tm
en
t in pregnanc
y: r
e
la
ti
onship to ad
verse pregnancy outcome,”
J. Reprod. Immunol.
, vol. 112, pp. 1–
10, 2015
.
[10]
O.
O.
Onigbinde,
et a
l
.
, “Periodontal Status and Some
Variables among Pregn
a
nt Wo
men in a Nigeria Tertiar
y
Institution
,
”
Ann
.
Med
.
H
e
alth
Sc
i.
Res.
, vo
l/issue: 4(6), pp. 852–8
57, 2014
.
BIOGRAP
HI
ES OF
AUTH
ORS
Name: Rikaw
a
rastuti
Em
ail:
rikaw
a
ras
t
uti@gm
ail
.
com
Educational B
a
ckground:
1.
Master Degr
ee
in Public Health
Sc
ience, Univers
itas Indon
esia, 2
003
2.
Bachelor Degr
ee in Public H
eal
th
, Universitas Ind
onesia, 2001
Organization
an
d Working Exp
e
riences:
1.
Lecturer
in Poltekkes Jakarta I
,
2
011 up to
now
2.
Member of IAKMI, 2014 up
to
n
o
w
Name: drg. Nita
Noviani Har
a
hap, MKM
Email: nita.nov
iani@
y
ahoo
.com
Educational B
a
ckground:
1.
Bachelor Degr
ee in Den
tistr
y
,
Un
iversitas Trisak
ti, 1988
2.
Master Degr
ee
in Health Promotion and
Beh
a
vio
r
al Sciences, Universitas Indon
esia, 2010
Organization
an
d Working Exp
e
riences:
1.
Lecturer
in Poltekkes Jakarta I
,
1
989 up to
now
2.
Member of PDGI, 1989
up to
no
w
Name: Ngatemi, S.
SiT, MKM
Email: Ngatemi02@
y
a
hoo
.com
Educational B
a
ckground:
1.
Diploma in D
e
ntistr
y
,
Univ
ersitas Gajah M
a
da, 2
002
2.
Master Degr
ee
in Public Health
Service Quality
,
2012
Organization
an
d Working Exp
e
riences:
1.
Lecturer
in Poltekkes Jakarta I
,
2
011 up to
now
2.
Member of PPGI, 1987
up to
no
w
Evaluation Warning : The document was created with Spire.PDF for Python.