Effect of Periodontal Disease Treatment During Pregnancy on Preterm Birth Incidence: A Meta-analysis of Randomized Trials

Polyzos, N.P.; Polyzos, Ilias P; Mauri, Davide; Tzioras, Spyridon; Tsappi, Maria; Cortinovis, Ivan; Casazza, Giovanni

doi:10.1097/01.aoa.0000367008.55760.9f

Cited by 17 publications

(23 citation statements)

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“…At this point, there is not sufficient evidence to determine whether periodontal disease simply does not increase risk for preterm birth or whether it does increase risk but treatment as performed in this study was ineffective in decreasing preterm birth. This is in contrast to the recent meta-analysis by Polyzos etal,24 which includes data from seven trials including the large OPT trial. This meta-analysis concludes that periodontal therapy reduces the risk of preterm birth for gestational age less than 37 weeks (overall OR 0.55, 95% CI 0.35–0.86, P =.008, n=2,527 births).…”

Section: Discussionmentioning

confidence: 76%

Effects of Periodontal Therapy on Rate of Preterm Delivery

Offenbacher

Beck

Jared

et al. 2009

Obstetrics &Amp; Gynecology

214

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OBJECTIVE To test the effects of maternal periodontal disease treatment on the incidence of preterm birth (delivery before 37 weeks of gestation). METHODS The Maternal Oral Therapy to Reduce Obstetric Risk Study was a randomized, treatment-masked, controlled clinical trial of pregnant women with periodontal disease who were receiving standard obstetric care. Participants were assigned to either a periodontal treatment arm, consisting of scaling and root planing early in the second trimester, or a delayed treatment arm that provided periodontal care after delivery. Pregnancy and maternal periodontal status were followed to delivery and neonatal outcomes until discharge. The primary outcome (gestational age less than 37 weeks) and the secondary outcome (gestational age less than 35 weeks) were analyzed using a χ2 test of equality of two proportions. RESULTS The study randomized 1,806 patients at three performance sites and completed 1,760 evaluable patients. At baseline, there were no differences comparing the treatment and control arms for any of the periodontal or obstetric measures. The rate of preterm delivery for the treatment group was 13.1% and 11.5% for the control group (P=.316). There were no significant differences when comparing women in the treatment group with those in the control group with regard to the adverse event rate or the major obstetric and neonatal outcomes. CONCLUSION Periodontal therapy did not reduce the incidence of preterm delivery. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, www.clinicaltrials.gov, NCT00097656. LEVEL OF EVIDENCE I

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Section: Discussionmentioning

confidence: 76%

Effects of Periodontal Therapy on Rate of Preterm Delivery

Offenbacher

Beck

Jared

et al. 2009

Obstetrics &Amp; Gynecology

214

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“…While it is well established that maintaining good oral health during pregnancy will reduce the risk of early childhood caries 5,14,15 there is still inconclusive data on whether pregnancy outcomes will be improved 16–18 . Although the most recent meta‐analysis of randomised control trials 19 did find that periodontal treatment during pregnancy could reduce the rate of PTB and LBW infants, subsequent large trials have not corroborated these findings 16,18,20 . A recent trial involving 1082 women with periodontal disease found that periodontal treatment during pregnancy did not prevent nor cause PTB, fetal growth restriction or pre‐eclampsia 18 .…”

Section: Introductionmentioning

confidence: 99%

Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials

George

Shamim

Johnson

et al. 2011

International Journal of Evidence-Based Healthcare

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“…However, environmental, occupational, and comorbidity factors may impact a pregnancy outcome either singly or in combination, regardless of PD. 31,53 Periodontal therapy may require more than one treatment to assist patients to achieve a healthy periodontal status. 12,15,52 Factors such as access to healthcare insurance and dental care, economic status, and cultural and educational differences can predispose women to periodontal disease and should be considered in future study design.…”

Section: Discussionmentioning

confidence: 99%

“…28 An association has been identified between PLBW and the presence of microbial invasion of the amniotic cavity. 8,[29][30][31][32][33] In an attempt to better understand the possible relationship between periodontal disease and pregnancy outcomes, several reviews and meta-analysis reports have been published. This bacterium was found in collections of amniotic fluid and subgingival plaque samples in women having threatened premature labor, that is, premature rupture of membranes without clinical infection or labor.…”

Section: Review Of the Evidence Periodontal Disease And Preterm/low Bmentioning

confidence: 99%