Conhecimentos, atitudes, práticas e condição bucal de mulheres com gravidez de alto risco em hospital de referência em uma cidade do nordeste do Brasil

Abstract

Introduction: Physiological changes during pregnancy may increase susceptibility to oral diseases, which can be associated with obstetric complications, especially in high-risk pregnancies. Objective: To analyze the knowledge, attitudes, practices, and oral health status of high-risk pregnant women, as well as their sociodemographic profile and the association between sociodemographic factors and oral health indices. Methods: This was a cross-sectional,

observational, and analytical study conducted with 120 pregnant women hospitalized in a maternal- infant university hospital. Sociodemographic data were collected, and questionnaires assessing

knowledge, attitudes, and practices were administered. Clinical examination was performed using the DMFT index (Decayed, Missing, and Filled Teeth) and the Community Periodontal Index (CPI). Data were analyzed using descriptive and inferential statistics (α=5%). Results: The participants had a mean age of 28.6 years and showed high socioeconomic vulnerability (68.3% with income ≤1 minimum wage), with a mean of 2.54 pregnancies and a mean gestational age of 27.29 weeks. High levels of perception and positive attitudes (>90%) were observed, along with good oral hygiene practices (96.7% brushing ≥2 times/day; 80.8% flossing) and high adherence to dental visits (88.3%). However, knowledge gaps persisted regarding the influence of maternal oral health on fetal health (54.2%) and the timing of early dental care for infants (75.8%). Clinically, 88.3% required periodontal intervention, with a mean DMFT of 4.53 and a low prevalence of healthy periodontium (11.7%), with calculus (53.3%) and bleeding on probing (30.0%) being the most frequent findings. No statistically significant association was found between total DMFT and sociodemographic variables (p>0.05). However, family income was associated with the number of decayed teeth (p=0.018), with higher means among lower-income women, and education level was associated with the number of filled teeth (p=0.012), with higher means among those with higher education. Regarding periodontal status, no association was found with age or education (p>0.05), whereas a significant association was observed with income (p<0.001), indicating worse periodontal conditions among lower-income women. Conclusion: Although the participants reported positive attitudes and practices, a high burden of oral disease and need for periodontal intervention were observed, highlighting a discrepancy between self-reported behavior and clinical condition. Knowledge gaps remain, particularly regarding the relationship between maternal oral health and fetal health. The association between low income and poorer oral health outcomes reinforces the role of socioeconomic determinants and the need to strengthen educational actions and integrate dental care into prenatal assistance.