Background: Our objective was to describe the oral health of pregnant women, to determine oral health changes during pregnancy, and to determine factors associated with maternal periodontal health or disease.

Materials and Methods: Between December 1997 and July 2001, 1,224 pregnant women at <26 weeks’ gestation were enrolled in the study and oral health examinations were performed at enrollment and within 48 hours of delivery. Demographic, medical, and health behavior data were determined by chart abstraction and questionnaire. Comparisons between oral health at enrollment and delivery were made by student t test or Fisher’s exact test. Ordinal logistic regression analysis was used to identify risk factors for maternal periodontal disease.

Results: Among 903 women, there was a significant increase in those with health/periodontal disease absence between enrollment and delivery (P <0.001). However, we also observed a significant increase in women with four or more sites with attachment loss ≥2 mm or ≥3 mm (P <0.05, 0.001). Race, smoking, and insurance status were significantly associated with maternal periodontal disease. Black women were more likely than white women to have periodontal disease at enrollment (adj. odds ratio 2.9, 95% confidence interval 2.2 to 3.9) and delivery (adj. odds ratio 3.1, 95% confidence interval 2.2 to 4.2), and experience incident disease (adj. odds ratio 2.3, 95% confidence interval 1.6 to 3.4).

Conclusions: Oral health examinations were well accepted by pregnant women. An increase in attachment loss may represent active periodontal infection accelerated by pregnancy. Further study on racial disparity in oral health among pregnant women is needed. Continued efforts to evaluate and establish appropriate definitions of oral disease in pregnancy are warranted. J Periodontol 2004;75:116-126.