This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Objective: To conduct a small case-control study to determine the extent of periodontal disease in Asian and Pacific Islander diabetic and non-diabetic women who have term and pre-term babies. This pilot study is ongoing at Kapiolani Medical Center for Women and Children, and to date, we have enrolled 200 patients. Preliminary analysis indicates that periodontal disease measures do differ among the four subgroups in the study. The four groups have a similar number of teeth at risk for periodontal disease. Preterm diabetics have significantly more periodontal pockets than both term and preterm non-diabetics. Preterm diabetics have significantly more sites with attachment loss of ? 3mm, and more sites that bleed after probing than term non-diabetic subjects. Finally when compared to term births in non-diabetic women, diabetic women with preterm births have 6.0 times the odds of having moderate to severe periodontal disease. Similarly, diabetic women with term babies had 4.0 times the odds of having moderate to severe periodontal disease, and non-diabetic women had 2.9 times the odds. While these odds ratios are unadjusted for established risk factors for preterm birth, analyses in other populations indicated little confounding was present and the odds ratios remained significant. The preliminary data suggests diabetic Asian and Pacific Islander pregnant women have a high rate of periodontal disease. The rate of periodontal disease was higher in women delivering preterm compared to women delivering at term. Preterm diabetics had the highest rate of periodontal disease when compared to term diabetics, term non-diabetics and preterm non-diabetics. Periodontal disease may be a potentially modifiable and treatable cause of preterm birth, and it seems to occur at a particularly high rate amongst pregnant diabetics. This is important to our population here in Hawaii as we have a high rate of diabetes, particularly among the Native Hawaiian population.
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