Anxiety, depression, and oral health among US pregnant women: 2010 Behavioral Risk Factor Surveillance System.
OBJECTIVE
Maternal periodontal disease is associated with adverse perinatal outcomes. Anxiety and depression adversely impact oral health in nonpregnant women; however, this association has not been evaluated during pregnancy, a time characterized by higher rates of anxiety and depression. Therefore, we examined the association between these factors and oral disease and oral healthcare utilization among 402 pregnant respondents to the 2010 Behavioral Risk Factor Surveillance System.


METHODS
Self-reported lifetime diagnoses of anxiety, depression, and current depression were assessed. Oral health outcomes included self-reported tooth loss and dental visits in the past year.


RESULTS
One-fifth (21.2 percent) of respondents reported a tooth loss and 32.5 percent reported nonuse of oral health services. The prevalence of lifetime diagnosed anxiety and depression was 13.6 percent and 11.3 percent, respectively, whereas 10.6 percent reported current depression. After adjusting for risk factors, pregnant women with diagnosed anxiety had increased odds of one or more tooth loss [odds ratio (OR) = 3.30; 95 percent confidence interval (CI): 1.01-10.77] compared with those without the disorder. Similarly, after adjusting for socioeconomic factors, women with anxiety had increased odds of nonuse of oral health services (OR = 2.67; 95 percent CI: 1.03-6.90); however, this was no longer significant after adjusting for health behaviors and body mass index. We observed no significant association with depression.


CONCLUSIONS
In this population-based sample, we found a two- to threefold increased odds of tooth loss and nonuse of oral health services among pregnant women with a lifetime diagnosis of anxiety. To our knowledge, this is the first study to examine these associations among pregnant women.
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Marushka L
ML
Silveira
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Brian W
BW
Whitcomb
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Penelope
P
Pekow
Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
Elena T
ET
Carbone
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Lisa
L
Chasan-Taber
D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D040343:Behavioral Risk Factor Surveillance System; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D009059:Mouth Diseases / Q000453:epidemiology*; D009909:Oral Health; D011247:Pregnancy; D012959:Socioeconomic Factors; D016388:Tooth Loss / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
anxiety; dental visits; depression; pregnancy; tooth loss