ReviewEffect of periodontal disease treatment during pregnancy on preterm birth incidence: a metaanalysis of randomized trials
Section snippets
Background and objective
Preterm birth (PTB) rate affects almost 12-13% of pregnancies in the United States and 5-9% in Europe and developed countries.1 PTB is the number 1 cause of neonatal morbidity and mortality and causes 75% of neonatal deaths that are not a result of congenital anomalies. Although most preterm babies survive, they are at increased risk of neurodevelopmental, respiratory, and gastrointestinal complications.2
Approximately 70% of cases of PTB are spontaneous and no specific cause can be identified.3
Identification of randomized studies
Two independent investigators (D. M. and S. T.) searched the Cochrane Central Trials Registry, Web of Science, and Medline without year and language restriction. The last search was updated in January 2008. Results were compared and a consensus was reached with the involvement of a third investigator (I. P. P.). We used the following searching algorithm: (periodontal disease or periodontitis or gingivitis) and (preterm labor or PTB or premature rupture of membranes or PROM or LBW). In addition,
Eligible trials characteristics
The electronic searches yielded 429 items; 246 from Medline, 173 from Web of Science, and 10 from Cochrane Central. Of those, 18 reports were scrutinized in full text. Eleven reports were considered ineligible. Seven randomized trials were recorded. There were 2663 patients: 1491 had been randomized to receive periodontal treatment and 1172 to no treatment (Figure 1).
Table 1 shows the key characteristics of the included trials.
Design and quality characteristics
Three trials reported an adequate randomization mode,9, 13, 14
Comment
Our metaanalysis provides evidence in favor of the treatment of periodontal disease during pregnancy. Despite moderate between-study heterogeneity we observed for 2 of the primary outcomes, treatment with scaling and root planing reduces the rate of PTB and may reduce the rate of LBW infants. Mechanisms by which surgical treatment of periodontal disease might reduce PTB risk remain unknown. It is likely that the benefit of treatment of periodontal disease is related to the decline of oral
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2019, Dental Clinics of North AmericaAn Umbrella Review Exploring the Effect of Periodontal Treatment in Pregnant Women on the Frequency of Adverse Obstetric Outcomes
2018, Journal of Evidence-Based Dental PracticeCitation Excerpt :This situation was common in the reviews since they implemented different periodontal indexes and different ways to establish the magnitude and severity of the periodontal disease.32-35,37-44,46-49 Other reviews considered the sources of publication bias that influence the selection of the studies included and the findings reported for the authors in the descriptive/statistical analyses.34-36,38,39,41,43,46,47,49 Finally, a few reviews analyzed gaps in the type of periodontal therapy38-41,48 and the variability in the conceptual definitions for the adverse obstetric outcomes.34,35
No association between periodontitis, preterm birth, or intrauterine growth restriction: Experimental study in Wistar rats
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :The results of studies conducted in humans are controversial, but there is a tendency to more controlled studies finding less association between periodontal disease and PTB and LBW.30-32 Systematic reviews and metaanalyses on the effect of periodontal treatment in the prevention of these adverse outcomes were published,33,34 and they also tend to obtain no association results because they are executed more rigorously. Clinical studies on this subject, free of biases, are difficult to implement, whereas adverse outcomes such as PTB and LBW have >40 risk factors.35
Changes in inflammatory mediators in gingival crevicular fluid following periodontal disease treatment in pregnancy: Relationship to adverse pregnancy outcome
2015, Journal of Reproductive ImmunologyIdentification of a gene in Mycoplasma hominis associated with preterm birth and microbial burden in intraamniotic infection
2015, American Journal of Obstetrics and GynecologyMaternal microbiome and pregnancy outcomes
2015, Fertility and Sterility
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