Initial Psychometric Testing of a Brief Maternal Oral Symptom Survey

Introduction Oral health is an important component of maternal health. Pregnant women face unique oral health challenges. Although there is abundant evidence of the strong association between poor oral health and adverse pregnancy outcomes, oral health assessment is frequently overlooked by prenatal care providers. The purpose of this study was to test the reliability and validity of a brief maternal oral symptom survey for potential use by prenatal care providers to screen pregnant women for oral health concerns. Methods This study provides results of preliminary psychometric testing of a brief maternal oral symptom survey. The survey was administered to 455 pregnant African American women at 2 time points: early pregnancy (8-14 weeks) and late pregnancy (24-30 weeks). Saliva samples were collected on a small subset of the larger sample (n = 34). Cronbach's alpha was used to measure the internal consistency of the survey. Content validity was assessed using an expert panel (n = 32), and criterion validity was assessed by testing the association of survey items with salivary biomarkers. Results The oral health survey showed moderate overall content validity. Scores on the content validity index identified that 5 out of 10 survey items were relevant, clear, and important. Log-transformed C-reactive protein levels were associated with reported "dry mouth" and education. Cronbach's alpha value was 0.502. Discussion Suggested revisions of the oral symptom survey include removing items that performed poorly on the content validity index and additional inclusion of sociodemographic variables. With further testing and validation, this survey has the potential to be an effective screening tool to assess for prenatal oral health concerns that increase risk for poor birth outcomes.