The Association between Maternal Periodontitis and Preterm Birth: A Case-Control Study in a Low-Resource Setting in Sudan, Africa

Abstract

Background and Objectives: Vast data have been published recently on the association between periodontitis and preterm birth (PB). However, these studies have shown inconsistent results. Few of them were conducted in Africa, and data has not been published on the association between periodontitis and PB in Sudan. Materials and Methods: A case-control study was conducted at the Omdurman maternity hospital in Sudan from February through October 2021. The cases were women with spontaneous PB (<37 weeks), and healthy women with TB (37–42 weeks) were the controls. Questionnaires (demographics, medical and obstetric factors) were completed through face-to-face interviews. Periodontitis was diagnosed by the Community Periodontal Index as: “bleeding on probing and a pocket depth of ≥3 mm and clinical attachment loss of ≥6 mm, calculus with plaque deposits, and gingival recession”. Multivariate regression analysis was performed with PB as the dependent variable. Results: One hundred sixty-five women were enrolled in each arm of the study. The age, parity and body mass index did not significantly differ between the women with PB and those with TB. Compared with the controls, a significantly higher number of women with PB had periodontitis (50/165 (30.3%) vs. 30/165 (18.2%), p = 0.011). The association between periodontitis and PB was significant. Women who had periodontitis had double the odds of having PB compared to women who had no periodontitis (adjusted Odd Ratio = 2.05, 95% Confidence Interval = 1.20–3.52). Moreover, the haemoglobin level (adjusted Odd Ratio = 0.67, 95% Confidence Interval = 0.51–0.88) was inversely associated with PB. Conclusion: The study results indicate that periodontitis and low haemoglobin were strongly associated with PB. Preventive measures, including the use of periodontitis screening and the prevention of anaemia, are needed to reduce PB in this setting.

Maternal periodontitis as a risk factor for preterm birth: A cross-sectional study

“…The study stated that women with periodontitis had a two-fold greater chance of delivering preterm babies than women who had no periodontitis (odds ratio = 2.05). 24 A retrospective unmatched case‒control study in Rwanda concluded that women with periodontitis had six-fold higher chances of premature delivery than periodontally healthy women (odds ratio: 6.360). 25 In 2020, a hospital-based cross-sectional study using postpartum full-mouth periodontal examination reported that women with severe periodontitis had 3.46-fold higher odds of preterm births than non-periodontitis pregnant women.…”

Maternal Periodontitis as a Risk Factor for Preterm Birth: A Cross-Sectional Study

“…A case-control study in Africa assessed the association between periodontitis and preterm births using the Community Periodontal Index. The study stated that women with periodontitis had a 2X greater chance of delivering preterm babies than women who had no periodontitis (odds ratio = 2.05) (24). A retrospective unmatched casecontrol study in Rwanda concluded that women with periodontitis had 6X more chances of premature delivery than periodontally healthy women (odds ratio: 6.360) (25).…”

Incorporating basic periodontal screening into antenatal care services provided in Rwanda: A policy brief

“…A study in Kenya reported that women with periodontitis have 2 times risk of giving birth to preterm babies than women without periodontitis. 12 In Ethiopia, a study reported 2-4 times the odds of giving birth to preterm babies in women with periodontitis 13 while in Rwanda is six-fold risk of preterm in women with periodontitis than those with no periodontitis. 14 A recent study in Rwanda showed a high prevalence of periodontitis (60.5%) among pregnant women and a six-fold risk of preterm deliveries in women who had periodontitis.…”