Poor oral health as a predictor for preterm births: Do we need to revisit antenatal care guidelines for reducing preterm births? Reflections from rural Gujarat

Abstract

Background: Prematurity is one of the leading cause of under-5 deaths and single most important cause of neonatal mortality globally as well as in India. Still, there is a dearth of field-based research on preterm births (PTB) and its risk factors, especially in high burden countries like India. Evidence from developed countries indicates a possible association between poor oral health and PTB. However, the lack of similar evidence in India leads to a pressing need to conduct such studies. Objectives: The present study focuses on descriptive review and triangulates the observation with a cohort study conducted in Gujarat for exploring risk factors for PTB. Materials and Methods: A descriptive review on the association between PTB and periodontal disease was done using search engine such as PubMed and Google Scholar. The findings were triangulated with the observation of a cohort study conducted among 2154 antenatal mothers in four districts of Gujarat, India. Results: A number of studies have investigated the potential association between periodontal diseases and PTB but results are controversial; however, a community-based cohort study from Gujarat identified periodontal disease as an independent risk factor for PTB (adjusted odds ratio - 11). Conclusion: Although various studies highlighted that periodontal disease is an independent risk factor for PTB, oral health is often neglected during pregnancy. Simple oral health screening and treatment can play crucial role in the prevention of periodontal diseases. Unfortunately, in current antenatal care guidelines, oral health screening is missing. Hence, there is a dire need for strengthening guidelines including encouraging women to seek oral screening, counseling on maintaining appropriate oral hygiene during pregnancy.