540: Association of periodontal disease involving teeth numbers 7-10 or 23-26 and preterm labor

Abstract

Periodontal disease and dental abscesses are established risk factors for preterm labor. Embryological origins of respective teeth are through to influence the organ systems of their associated origin. This study seeks to evaluate if periodontal disease/dental abscesses of those teeth associated embryologically with the female reproductive organs, number 7-10 or 23-26, is associated with adverse labor outcomes as compared to other locations. We conducted a retrospective cohort study and reviewed medical charts and dental records on all women diagnosed with periodontal disease/dental abscesses in the third trimester of pregnancy at our academic institution and affiliated dental clinic. Inclusion criteria included pregnant women 18-55 years old diagnosed with dental abscess with adequate dental records, gestational age >34 weeks gestational age, and no other diagnosis leading to preterm labor. The primary outcome evaluated was the development of preterm labor with known periodontal disease/dental abscess in the third trimester. The study included 31 patients, 16 patients with periodontal disease/dental abscesses involving teeth number 7-10 or 23-26, and 15 with periodontal disease/dental abscesses of other locations. When compared with the teeth of other locations, periodontal disease/dental abscess involving teeth number 7-10 or 23-26 had higher incidence of preterm labor 15.1% (95% CI 11.3-19) versus 8.2% (95% CI 5.5-11.6), p = 0.044. In crude analysis, compared with the teeth of other locations, periodontal disease/dental abscess involving teeth number 7-10 or 23- 26 had higher risk of preterm labor (RR 1.66, 95% CI 1.13-1.99, p = 0.01). After adjusting for BMI, diabetes mellitus, gestational blood pressure >140/90, group b-Streptococcus status, race, advanced maternal age (>34 y), type of previous cesarean scar (low transverse, classical, or unknown) and parity, this risk was consistently demonstrated (RR 1.31, 95% CI 1.08-1.55, p = 0.05). Pregnant women in the third trimester with dental abscesses involving teeth numbers 7-10 or 23-26 have an increased risk of preterm labor compared with other locations and may be considered an additional risk factor for preterm labor in addition to the already established risk of periodontal disease/dental abscess and preterm labor in general.