Social Determinants of Oral Health Behaviors in Iranian Pregnant Women: A Cross-sectional Study

Document Type : Original Research Article

Authors

1 a) PhD Student of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

2 a) Associate Professor, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical, Mashhad, Iran

3 a) Associate Professor, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran

4 Assistant Professor, Department of Restorative and Cosmetic Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran

10.22038/jmrh.2024.78102.2330

Abstract

Background & aim: Performing oral health behaviors during pregnancy is crucial for maternal and fetal health, affecting both short-term and long-term health outcomes. In Iran, like many other countries, behavioral and social factors influence the oral health of pregnant women. This study investigated social determinants related to oral health behaviors in Iranian pregnant women.
Methods: This cross-sectional study was conducted on 300 pregnant women who were selected through a multi-stage cluster random sampling over the two months from December 2022 to January 2023 in Mashhad, Iran. Data on two key social determinants— access to educational services and support from family and friends—were collected using a researcher-developed questionnaire with acceptable validity and reliability. Statistical analyses were performed using the Mann–Whitney test, Kruskal–Wallis test, Spearman correlation, and univariate regression model in SPSS version 22.  
Results: All participants completed the questionnaire. The results showed that 71% of participants used to brush their teeth daily and 18% used dental floss. A significant association was found between oral health behaviors and employment status (β = 0.335, P = 0.034), educational level (β = 0.315, P = 0.006), access to educational services (β = 0.154, P = 0.022), and support from family and friends (β = 0.193, P = 0.003). The regression models accounted for 12% of the variance in oral health behavior scores.
Conclusion: This study underscored the significance of social determinants in influencing oral health behaviors among pregnant women. These insights can aid healthcare providers in delivering tailored services during pregnancy.

Keywords

Main Subjects

References

  1. Yunita Sari E, Saddki N, Yusoff A. Association between Perceived Oral Symptoms and Presence of Clinically Diagnosed Oral Diseases in a Sample of Pregnant Women in Malaysia. International Journal of Environmental Research and Public Health. 2020; 17(19):
  2. Yenen Z, Ataçağ T. Oral care in pregnancy. Journal of the Turkish German Gynecological Association. 2019; 20(4):
  3. Jafri Z, Bhardwaj A, Sawai M, Sultan N. Influence of female sex hormones on periodontium: A case series. Journal of Natural Science, Biology and Medicine. 2015; 6(Suppl 1): S146-S14
  4. Azofeifa A, Yeung LF, Alverson CJ, Beltrán‐Aguilar E. Dental caries and periodontal disease among US pregnant women and nonpregnant women of reproductive age, National Health and Nutrition Examination Survey, 1999–2004. Journal of Public Health Dentistry. 2016; 76(4): 320-32
  5. Al Agili DE, Khalaf ZI. The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women. BMC Pregnancy and Childbirth. 2023; 23(1):
  6. Hosseini B, Malekmohammadi T, Naderi T, Bakhtiary M, Hosseini Dastnaei P, Mafi S. Oral and Dental Health Status of Pregnant Women Referred to Perinatal Clinics in Southeastern Iran. Journal of Research in Dental and Maxillofacial Sciences. 2023; 8(2) :79-87.
  7. Ahmadi-Motamayel F, Safabakhsh D, Refaei M. Iranian Women and Health Care Providers' Perception of Oral Health in Pregnancy: A Qualitative Research. The Journal of Research Development in Nursing and Midwifery. 2023; 28(2): 155-159.
  8. Hemalatha VT, Manigandan T, Sarumathi T, Aarthi Nisha V, Amudhan A. Dental considerations in pregnancy-a critical review on the oral care. Journal of Clinical and Diagnostic Research. 2013; 7(5): 948.
  9. Zakaria ZZ, Al-Rumaihi S, Al-Absi RS, Farah H, Elamin M, Nader R, Bouabidi S, Suleiman SE, Nasr S, Al-Asmakh M. Physiological changes and interactions between the microbiome and the host during pregnancy. Frontiers in Cellular and Infection Microbiology. 2022; 12:
  10. Adeniyi A, Donnelly L, Janssen P, Jevitt C, Kardeh B, von Bergmann H, Brondani M. Pregnant women's perspectives on integrating preventive oral health in prenatal care. BMC Pregnancy Childbirth. 2021; 21(1):
  11. Radwan-Oczko M, Hirnle L, Szczepaniak M, Duś-Ilnicka I. How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey. BMC Pregnancy and Childbirth. 2023; 23(1):
  12. Bao J, Huang X, Wang L, He Y, Rasubala L, Ren YF. Clinical practice guidelines for oral health care during pregnancy: A systematic evaluation and summary recommendations for general dental practitioners. Quintessence International. 2022; 53(4): 362-3
  13. Abdollahi M, Tehrani H, Mahdizadeh M, Nemati-Karimooy A, Gholian-Aval M. Perceptions and determinants of oral health care among Iranian pregnant women: a qualitative study. BMJ Open. 2024; 14(1): e080033.
  14. Istepanian RSH. Mobile Health (m-Health) in Retrospect: The Known Unknowns. International Journal of Environmental Research and Public Health. 2022; 19(7):
  15. Sharma S, Kumari B, Ali A, Yadav RK, Sharma AK, Sharma KK, Hajela K, Singh GK. Mobile technology: A tool for healthcare and a boon in a pandemic. Journal of Family Medicine and Primary Care. 2022; 11(1):
  16. Stoumpos AI, Kitsios F, Talias MA. Digital Transformation in Healthcare: Technology Acceptance and Its Applications. International Journal of Environmental Research and Public Health. 2023; 20(4):
  17. Zahid T, Alyafi R, Bantan N, Alzahrani R, Elfirt E. Comparison of the effectiveness of mobile app versus conventional educational lectures on oral hygiene knowledge and behavior of high school students in Saudi Arabia. Patient Preference and Adherence. 2020: 1901-190
  18. Bashirian S, Barati M, Barati M, Shirahmadi S, Khazaei S, Jenabi E, Gholami L. Promoting Oral Health Behavior during Pregnancy: A Randomized Controlled Trial. Journal of Research in Health Sciences. 2023; 23(2): e00584.
  19. Fakheran O, Keyvanara M, Saied-Moallemi Z, Khademi A. The impact of pregnancy on women’s oral health-related quality of life: a qualitative investigation. BMC Oral Health. 2020; 20(1): 1-10.
  20. De Oliveira Júnior AJ, Oliveira JM, Bretz YP, Mialhe FL. Online social networks for prevention and promotion of oral health: a systematic review. Canadian Journal of Dental Hygiene. 2023; 57(2):
  21. Lamarca GA, Leal MD, Leao AT, Sheiham A, Vettore MV. The different roles of the neighbourhood and individual social capital on oral health–related quality of life during pregnancy and postpartum: a multilevel analysis. Community Dentistry and Oral Epidemiology. 2014; 42(2): 139-1
  22. Tabachnick BG, Fidell LS. Using Multivariate Statistics Needham Heights. MA: Allyn & Bacon. 2001.
  23. Siskandar R, Indrawan NA, Kusumah BR, Santosa SH, Irmansyah I. Penerapan Rekayasa Mesin Sortir sebagai Penentu Kematangan Buah Jeruk dan Tomat Merah Berbasis Image Processing [Implementation of Sortir Machine Engineering as Determination of Maturity of Orange and Red Tomato Based on Image Processing].  Jurnal teknik pertanian Lampung. 2020; 9(3): 222-236.
  24. Chatripour R, Feizi A, Zamani-Alavijeh F, Beni AN, Mazaheri MA. Design and evaluating psychometric properties of the eye care behaviors assessment instrument. International Journal of Preventive Medicine. 2023; 14(1): 35.
  25. Goni MD, Naing NN, Hasan H, Wan-Arfah N, Deris ZZ, Arifin WN, Hussin TM, Abdulrahman AS, Baaba AA, Arshad MR. Development and validation of knowledge, attitude and practice questionnaire for prevention of respiratory tract infections among Malaysian Hajj pilgrims. BMC Public Health. 2020; 20(1): 189.
  26. Koo, Terry K., and Mae Y. Li. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine. 2016; 15: 155-163.
  27. Praharaj N, Naik D. Management of Oral Health During Pregnancy. Indian Journal of Forensic Medicine & Toxicology. 2020 Oct 1;14(4).
  28. Afshar MK, Torabi M, Bahremand M, Afshar MK, Najmi F, Mohammadzadeh I. Oral health literacy and related factors among pregnant women referring to Health Government Institute in Kerman, Iran. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2020;
  29. Mohammadkhah F, Amirhajelu RM, Bakhtiar M, Salemi SA, Kevenjan M, Jeihooni AK. The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women. BMC Oral Health. 2023; 23(1):
  30. Deghatipour M, Ghorbani Z, Ghanbari S, Arshi S, Ehdayivand F, Namdari M, Pakkhesal M. Oral health status in relation to socioeconomic and behavioral factors among pregnant women: a community-based cross-sectional study. BMC Oral Health. 2019; 19(1): 1-1
  31. Bushehab NME, Sreedharan J, Reddy S, D'souza J, Abdelmagyd H. Oral Hygiene Practices and Awareness of Pregnant Women about the Effects of Periodontal Disease on Pregnancy Outcomes. International Journal of Dentistry. 2022; 2022:
  32. Arima H, Calliope AS, Fukuda H, Nzaramba T, Mukakarake MG, Wada T, Yorifuji T, Mutesa L, Yamamoto T. Oral cleaning habits and the copy number of periodontal bacteria in pregnant women and its correlation with birth outcomes: an epidemiological study in Mibilizi, Rwanda. BMC Oral Health. 2022; 22(1):
  33. Hebbal M, AlSagob EI, Kotha SL, Santhosh VN, Kumar RS, Mertins S, Alharthi A, Aljubran N, Alqhtani S. Oral health-related knowledge, practice, and utilization of dental services among pregnant women in Riyadh, Saudi Arabia. Plos One. 2025; 20(4):
  34. Choi JW, Choi Y, Lee TH, Lee HJ, Ju YJ, Park EC. Employment status and unmet dental care needs in South Korea: a population-based panel study. BMJ Open. 2019; 9(3):
  35. Bunnatee P, Abdulsalam FI, Phoosuwan N. Factors associated with oral health care behaviors of pregnant women in a northeastern province in Thailand: A hospital-based cross-sectional study. Plos One. 2023; 18(8): e0290334.
  36. Althunayan A, Alsalhi R, Elmoazen R. Role of social media in dental health promotion and behavior change in Qassim province, Saudi Arabia. International Journal of Medical and Health Research. 2018; 4(2): 98-103.
  37. Vettore MV, Ahmad SF, Machuca C, Fontanini H. Socio‐economic status, social support, social network, dental status, and oral health reported outcomes in adolescents. European Journal of Oral Sciences. 2019; 127(2): 139-1
  38. Farrokhi F, Ghorbani Z, Farrokhi F, Namdari M, Salavatian S. Social media as a tool for oral health promotion: A systematic review. PLoS One. 2023; 18(12): e0296102.
  39. Jiang L, Zhu Z. Maternal mental health and social support from online communities during pregnancy. Health Soc Care Community. 2022; 30(6): e6332-e6344.
  40. Bugis BA. Patients Self-Reporting of Utilizing Tele dental Services During the COVID-19 Pandemic in Saudi Arabia. The Journal of Patient Experience. 2022; 9:
  41. Vamos CA, Merrell L, Livingston TA, Dias E, Detman L, Louis J, Daley E. “I didn't know”: Pregnant women's oral health literacy experiences and future intervention preferences. Women's Health Issues. 2019; 29(6): 522-52
  42. Dahlan R, Ghazal E, Saltaji H, Salami B, Amin M. Impact of social support on oral health among immigrants and ethnic minorities: A systematic review. PloS One. 2019; 14(6):
  43. Koletzko B, Cremer M, Flothkötter M, Graf C, Hauner H, Hellmers C, Kersting M, Krawinkel M, Przyrembel H, Röbl-Mathieu M, Schiffner U, Vetter K, Weißenborn A, Wöckel A. Diet and Lifestyle Before and During Pregnancy - Practical Recommendations of the Germany-wide Healthy Start - Young Family Network. Geburtshilfe Frauenheilkd. 2018; 78(12): 1262-1282.
  44. Hamid T, Kuntari S, Marzuqi N, Fauziah M. The Social Behaviour of Pregnant Mothers and the Mothers of Children under Five in Relation to their Children’s Dental Health and Growth. Journal of International Women's Studies. 2019; 20(9): 54-67. 
Journal of Midwifery and Reproductive Health
Volume 14, Issue 1
January 2026
Pages 5255-5264

Files

Share

How to cite

Statistics