Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the Network Perspective

Abstract

Oral healthcare during pregnancy needs to be part of the assistance routine given to pregnant women by health professionals as a way to encourage self-care and strengthen the general health of the mother and the baby. The aim of this study was to evaluate the effectiveness of an integrated oral healthcare intervention for pregnant women and to analyze the association of sociodemographic, behavioral, oral health and general maternal and child health factors in prenatal care at usual risk in primary care in a city in the northeast of Brazil, in 2018-2019. A controlled, randomized, single-blinded community trial was conducted. The intervention group (IG) received dental assistance and collective health education actions in conversation circles, while the control group (CG) received the usual assistance. All pregnant women (146 in total, 58 from IG and 88 from CG) that took part in the trial answered a questionnaire and underwent a dental examination at the beginning of prenatal care and at the puerperal visit. To assess the effect of the intervention, a network analysis was used. The results have shown that being in the control group was associated with neonatal complications (0.89) and prematurity (0.54); the use of tobacco and alcohol are associated with high risk in initial and final oral health; lower educational level of the pregnant women implicates high risk for initial oral health (-0.19), final oral health (-0.26), pregnancy complications (-0.13), low birth weight (-0.23), prematurity (-0.19) and complications in the newborn (-0.14). Having a low family income (≤261.36 USD) has shown a high risk for initial oral health (-0.14), final oral health (-0.20) and prematurity (-0.15). The intervention based on integrated oral healthcare for pregnant women indicated that socioeconomic and behavioral factors must be considered as determinants for the quality of women and children's health and that multi-professional performance during prenatal care contributes to the positive outcomes of pregnancy.

Keywords: clinical trial; integrality in health; network perspective; oral health; prenatal care.

Figure 1

CONSORT flowchart for selecting and monitoring group participants. Municipality of northeastern Brazil, 2019.

Figure 2

Network perspective of the association between sociodemographic and behavioral factors, group (intervention and control) and mother–child oral health. 1: Group; 2: Initial oral health risk; 3: Final oral health risk; 4: Age; 5: Educational level; 6: Income; 7: Home water; 8: Oral hygiene; 9: Smoking; 10: Alcohol; 11: Maternal complications; 12: Birth weight; 13: Baby’s complications at birth; 14: Prematurity.