Abstract
BackgroundTo explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy.MethodsWe conducted a retrospective cohort analysis of insurance claims data from 2009 to 2012 for women who delivered a singleton live birth (n = 32,168). IUGR was examined as a function of type and timing of dental treatment, adjusting for potential confounders in logistic regression. Sensitivity analysis evaluated the potential effects of unmeasured confounding.ResultsWomen who received periodontal treatment after delivery, indicating the presence of untreated periodontal disease during pregnancy, had significantly higher odds of IUGR compared to women who received no periodontal treatment (adjusted OR 1.5, 95% CI 1.2, 1.8).ConclusionsPeriodontal treatment provided in the immediate postpartum period, a proxy for periodontitis during gestation, was associated with increased risk of IUGR.
Highlights
To explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy
To determine whether risk of IUGR increases with severity of periodontitis, we examined the rate of IUGR in relation to the number and type of periodontal treatment procedures, and compared women who received surgical as opposed to non-surgical periodontal treatment
The results indicate an association between maternal periodontal disease and odds of IUGR
Summary
To explore the hypothesis that maternal periodontitis is associated with increased risk for Intrauterine Growth Restriction (IUGR), we examined the risk of IUGR in relation to periodontal treatment before, during and after pregnancy. The etiology of IUGR remains undetermined, but several risk factors for the condition have been identified These include advanced maternal age, increased parity, smoking during pregnancy, low pre-pregnancy body mass index and low gestational weight gain (due to low energy intake), short maternal stature, poor maternal nutrition, maternal race/ethnicity, and low socioeconomic status being some of the Periodontal diseases are associated with transient bacteremia that may facilitate dissemination of oral bacteria to the uterus, with subsequent infiltration of the amniotic fluid and the umbilical cord and invasion of the placenta. Uteroplacental infection and inflammation are thought to play key roles in the etiology of IUGR [8], with fetal inflammatory response syndrome being characterized as the important cause of IUGR [9]. These infections account for up to 15% of IUGR cases [10]
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