Abstract
ObjectiveTo evaluate the association of periodontal disease (PD) in pregnancy with some adverse perinatal outcomes.MethodThis cohort study included 327 pregnant women divided in groups with or without PD. Indexes of plaque and gingival bleeding on probing, probing pocket depth, clinical attachment level and gingival recession were evaluated at one periodontal examination below 32 weeks of gestation. The rates of preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA) neonates and prelabor rupture of membranes (PROM) were evaluated using Risk Ratios (95%CI) and Population Attributable Risk Fractions.ResultsPD was associated with a higher risk of PTB (RRadj. 3.47 95%CI 1.62-7.43), LBW (RRadj. 2.93 95%CI 1.36-6.34) and PROM (RRadj. 2.48 95%CI 1.35-4.56), but not with SGA neonates (RR 2.38 95%CI 0.93 - 6.10).ConclusionsPD was a risk factor for PT, LBW and PROM among Brazilian low risk pregnant women.
Highlights
periodontal disease (PD) was associated with a higher risk of preterm birth (PTB) (RRadj. 3.47 95%CI 1.62-7.43), low birth weight (LBW) (RRadj. 2.93 95%CI 1.36-6.34) and prelabor rupture of membranes (PROM) (RRadj. 2.48 95%CI 1.35-4.56), but not with small for gestational age neonates (SGA) neonates (RR 2.38 95%CI 0.93 - 6.10)
Through the last 12 years, periodontal disease (PD) has been suggested to be associated with preterm, low birth weight (PTB/LBW), and small for gestational age neonates (SGA), which are associated with higher risk of perinatal mortality, mortality in the first year of life, development of health problems during childhood, and risk of diseases during adulthood [1]
Study Design This is a contemporary cohort study that evaluates the relationship between PD and preterm birth, low birth weight, prelabor rupture of membranes and small for gestational age neonates, performed with low risk pregnant women receiving prenatal care at the maternity of the University of Campinas, Brazil, who voluntarily agreed to participate in the study after signing an informed consent form
Summary
Through the last 12 years, periodontal disease (PD) has been suggested to be associated with preterm, low birth weight (PTB/LBW), and small for gestational age neonates (SGA), which are associated with higher risk of perinatal mortality, mortality in the first year of life, development of health problems during childhood (neurological, respiratory, gastrointestinal and cardiovascular), and risk of diseases during adulthood [1]. A number of intervention studies were carried out in an attempt to decrease adverse outcomes in pregnancy and the rate of PTB/LBW in populations after the treatment of PD, and concluded that PD seems to be an independent risk for PTB/LBW and that periodontal therapy in pregnant women with PD significantly reduces its occurrence [4,13,14] All suggested this relationship, recent randomized controlled trials on the treatment of PD during pregnancy did not find any decrease in the rates of PTB, LBW or fetal growth restriction [15,16]. These differences could be explained by a lack of power due to a small sample size, by inadequate adjustment for confounders or mainly by distinct definitions of periodontitis [17]
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