Effects of Periodontal Therapy on Rate of Preterm Delivery

Abstract

It is unclear whether treatment of maternal periodontal disease will reduce the risk of preterm delivery. The results of 4 randomized single-center trials suggested that periodontal treatment during pregnancy may reduce preterm births. However, a randomized, multicenter clinical trial reported no difference between treatment and control groups for mean gestational age and preterm birth. This randomized, controlled clinical trial investigated the effects of treatment of periodontal disease on the incidence of preterm birth in women receiving standard obstetric care. Between 2004 and 2007 at 3 US sites, 1806 pregnant women with periodontal disease were randomized to either a periodontal treatment arm (n = 903), consisting of scaling and root planning early in the second trimester, or a delayed treatment arm (n = 903) that provided periodontal care only after delivery. The pregnancy and maternal periodontal status in all participants were followed to delivery and neonatal outcomes until discharge. The primary outcome was preterm birth defined as gestational age less than 37 weeks. The secondary outcome was gestational age less than 35 weeks. A total of 1760 evaluable patients were included in the final analysis. There were no differences at baseline in the treatment and control (delayed treatment) groups for any periodontal or obstetric measure. No statistically significant differences were found between the 2 groups in rates of preterm delivery or adverse events, or in major obstetric and neonatal outcomes. There were some differences among the individual study sites in effects of treatment on periodontal status. These findings demonstrate that periodontal therapy during pregnancy has no effect on rates of preterm delivery.