Women's oral health in the preconception period: correlates and consequences

项目摘要 牙周炎是人类最常见的慢性健康疾病，估计有38%的成年人患有牙周炎 美国的女性。研究表明牙周炎和其他疾病之间存在联系。 不良健康后果，包括先兆子痫、低出生体重和 早产。然而，评估怀孕期间牙周治疗的试验并没有发现一致的 对围产期结局的益处，表明可能需要在怀孕前建立口腔健康 来影响生育结果。因此，对预产期口腔健康的研究可能会提供重要的 洞察口腔健康促进的潜在机会，特别是因为尝试受孕 通常伴随着行为的改变。这位调查者先前的研究评估了先入为主的口腔 卫生部门发现，自我报告的先入为主的牙周炎与较长的 怀孕，但早孕牙周炎和其他围产儿结局之间的联系仍然存在 没有特征的。这项研究的目的是通过提供对 基于大型前瞻性数据的未孕期口腔健康的原因和后果 从女性计划怀孕开始跟踪她们的队列研究(例如，先入为主)。 具体地说，目标1将评估预产期口腔健康和牙科服务使用的预测因素。目标 2将利用目标试验框架来模拟随机对照试验，以评估 孕期牙周炎患者接受牙周炎治疗的先入之见。最后， 目标3将检查怀孕前牙周炎和自然流产(通常 称为流产)。综上所述，拟议中的项目有可能提供广泛的见解 进入未孕期女性的口腔健康。随附的培训计划与 研究目标，为申请者提供强有力的实践培训机会，以支持其过渡 给一位在观察性研究方法方面有专长的独立口腔健康流行病学家。培训 此外，计划还概述了赞助商和联合赞助商提供的量身定制的指导机会，他们都是 在各自领域内拥有成功合作记录的公认专家，以及 申请人。

Project Abstract Periodontitis is the most common chronic health condition in humans and affects an estimated 38% of adult women in the United States. Research has demonstrated a connection between periodontitis and other adverse health outcomes, including reproductive health outcomes of preeclampsia, low birthweight, and preterm birth. However, trials evaluating periodontal treatment in pregnancy have not found a consistent benefit for perinatal outcomes, suggesting that establishment of oral health prior to pregnancy may be required to influence birth outcomes. Thus, research into oral health in the preconception period may provide important insights into potential opportunities for oral health promotion, particularly because attempting conception is often accompanied with behavior changes. Prior research by this investigator evaluating preconception oral health found an association between self-reported preconception periodontitis and a prolonged time-to- pregnancy, but the association between preconception periodontitis and other perinatal outcomes remains uncharacterized. The aim of this research is to address this gap in the literature by providing insights into the causes and consequences of oral health in the preconception period using data from a large, prospective cohort study that follows women from the time they are planning a pregnancy (e.g., preconception). Specifically, Aim 1 will assess predictors of oral health and dental service use in the preconception period. Aim 2 will leverage a Target Trial Framework to emulate a randomized controlled trial to evaluate the impact of preconception receipt of periodontitis treatment among women with periodontitis on time-to-conception. Finally, Aim 3 will examine the association between preconception periodontitis and spontaneous abortion (commonly referred to as miscarriage). Taken together, the proposed project has the potential to provide broad insights into women’s oral health in the preconception period. An accompanying training plan dovetails with the research objectives to provide robust, hands-on training opportunities for the applicant to support her transition to an independent oral health epidemiologist with expertise in observational research methods. The training plan additionally outlines tailored mentorship opportunities from the sponsor and co-sponsors, all of whom are recognized experts in their fields with a track record of successful collaboration with each other and the applicant.