title: Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.
abstract: Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia dmcneil@wvu.edu.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: McNeil
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hayes
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Cameron L
authors.initials: CL
authors.lastname: Randall
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: Deborah E
authors.initials: DE
authors.lastname: Polk
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Neiswanger
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Shaffer
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Weyant
authors.affiliation: Center for Oral Health Research in Appalachia University of Michigan, Ann Arbor, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Foxman
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kao
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Crout
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Stella
authors.initials: S
authors.lastname: Chapman
authors.affiliation: West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Brown
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Maurer
authors.affiliation: Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Marazita
mesh_terms: D000293:Adolescent; D000328:Adult; D001061:Appalachian Region / Q000453:epidemiology; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D009909:Oral Health / Q000208:ethnology / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy; D011788:Quality of Life / Q000523:psychology; D012424:Rural Population; D014505:Urban Population
keywords: Appalachia; depression; health disparities; oral health; pregnancy; rural