Change in periodontitis during pregnancy and the risk of pre‐term birth and low birthweight

Abstract

Aim-Determine if periodontitis progression during pregnancy is associated with adverse birth outcomes.Materials and Methods-We used clinical data and birth outcomes from the OPT Study, which randomized women to receive periodontal treatment before 21 weeks gestation (N=413) or after delivery (410). Birth outcomes were available for 812 women and follow-up periodontal data for 722, including 75 whose pregnancies ended <37 weeks. Periodontitis progression was defined as ≥ 3mm loss of clinical attachment. Birth outcomes were compared between non-progressing and progressing groups using the log rank and t tests, separately in all women and in untreated controls.Results-The distribution of gestational age at the end of pregnancy (P > 0.1) and mean birthweight (3295 versus 3184 grams, P = 0.11) did not differ significantly between women with and without disease progression. Gestational age and birthweight were not associated with change from baseline in percent of tooth sites with bleeding on probing or between those who did versus did not progress according to a published definition of disease progression (P > 0.05).Conclusions-In these women with periodontitis and within this study's limitations, disease progression was not associated with increased risk for delivering a preterm or low birthweight infant.Scientific Rationale: Maternal periodontitis and disease progression during pregnancy have been associated with elevated risk for preterm birth. We used data from a recent clinical trial to explore possible associations between progressive periodontitis and birth outcomes.Principal Findings: The distribution of gestational age at delivery and mean birthweights did not differ significantly between women who experienced progressive periodontitis and those who did not.Corresponding Author: Bryan Michalowicz, 17-116 Moos Tower,

Is there a relationship between maternal periodontitis and pre-term birth? A prospective hospital-based case-control study

“…To date, only a few authors have investigated the association between periodontitis and very low birthweight pre-term delivery (£32 weeks and £1500 g) [39,40]. Our results are consistent with previous studies that found no significant association between periodontitis and the risk for pre-term birth at <37 weeks [39,40].…”

“…Our results are consistent with previous studies that found no significant association between periodontitis and the risk for pre-term birth at <37 weeks [39,40]. We also found no evidence that periodontal disease increases very pre-term birth risk of women (£32 weeks), as reported by Michalowicz et al [40], whereas Offenbacher et al [39] reported a positive relation between periodontitis and very pre-term birth (£32 weeks).…”

Relationship Among Mothers’ Glycemic Level, Periodontitis, and Birth Weight

“…The association between periodontitis and gestational complications, such as low birth weight (LBW), has been investigated widely for almost 2 decades, but there is still no consensus view 6–12 . The justification for this lack of consensus relates to other determinants that affect LBW and hence may camouflage the relationship with periodontitis.…”

Birth Weight of Infants of Mothers With Aggressive Periodontitis

“…It has been hypothesized that systemic inflammation, attributable to periodontal infection and bacterial colonization in the absence of adequate maternal antibody responses to specific periodontal pathogens, might contribute to such adverse outcomes. Notably, other studies have failed to reproduce the associations between periodontal diseases and pregnancy outcomes 8‐13 . Furthermore, although some studies 14,15 have shown that treatment of periodontal disease during pregnancy is of benefit to birth outcomes, 16 others have failed to show such an effect 17‐19 …”