Arch Gynecol Obstet. 2010 Dec 1. [Epub ahead of print]
Periodontal disease and perinatal outcomes.
Open Medical Institute, Salzburg, Austria
PURPOSE: To elucidate plausible associations between periodontal disease (PD) and pregnancy events through meta-analysis of original research published between 1998 and 2010.
METHODS: One hundred and twenty-five randomized, case-control, matched-cohort studies on pregnancy and postpartum specifics in women with PD are identified through PubMed, LILACS, and Cochrane Register. Meta-study is performed on a sample of 992 births allocated from studies of level I-II-1 evidence. An oral inflammation score (OIS) is composed from parameteric and observational components of maternal PD. Pearson arrival process is modeled for exchangeable correlations.
RESULTS: Women with preeclampsia and preterm birth have poor periodontal parameters in both, treatment and placebo groups (OR 1.94-2.9). In puerperae with severe periodontitis birth weight is negatively correlated with maternal probing depth (r = -0.368), and C-reactive protein (r = -0.416). Higher rates of tobacco use (RR 3.02), bacterial vaginosis (RR 2.7), clinical attachment level (OR 2.76), and fetal tyrosine kinase (OR 1.6) contribute in increased rates of preeclamsia (RR 1.68), and prematurity (RR 2.75). After adding confounders into the model OIS remains significantly associated with preterm birth (OR 2.3).
CONCLUSIONS: Maternal PD has strong associations with preeclampsia and prematurity.