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VOLUME 4 , ISSUE 4 ( October-December, 2013 ) > List of Articles

REVIEW ARTICLE

Effect of Periodontal Treatment on Preterm Birth Rate: Meta-analysis

Adel S Alobaid

Citation Information : Alobaid AS. Effect of Periodontal Treatment on Preterm Birth Rate: Meta-analysis. World J Dent 2013; 4 (4):256-261.

DOI: 10.5005/jp-journals-10015-1241

Published Online: 01-12-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

During pregnancy, the prevalence and severity of gingivitis have been reported to be elevated. Studies suggest that periodontitis is associated with an increased risk of preterm birth (PTB), as well as low birth weight (LBW) and pre-eclampsia. The purpose of this meta-analysis is to determine whether the treatment of periodontal disease by mechanical debridement and oral hygiene instructions during pregnancy will reduce the incidence of PTB < 37 weeks.

Materials and methods

Literature search was conducted for all clinical trials that related to periodontal disease and PTB from 2005 to 2012. Five were selected based no randomization technique, sample size and treatment approach. There were 2,767 patients randomly assigned to treatment group, in these trials, and 2,592 subjects randomly assigned to control group.

Results

There were 276 (9.98%) PTBs in treatment group vs 270 (10.42%) in control group. A total of 216 (8%) LBW were seen in experimental groups and 193 (7.5%) in control group. Our results showed no significant difference in the incidence of PTB with or without received periodontal treatment during pregnancy. Risk ratio (RR) was 0.99 (95% CI: 0.74-1.33) (p = 0.97) with moderate heterogeneity 12.33. df = 4 (p = 0.02) with I2= 68%. Experimental groups showed better periodontal health after delivery.

Conclusion

Periodontal treatment may improve the oral health during pregnancy without affecting the pregnancy outcome however; it did not reduce the incidence of PTB and LBW. Larger meta-analysis with less heterogeneity is needed.

How to cite this article

Alobaid AS. Effect of Periodontal Treatment on Preterm Birth Rate: Meta-analysis. World J Dent 2013;4(4):256-261.


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  1. Epidemiology and causes of preterm birth. Lancet 2008;371:75-84.
  2. Births: final data for 2005. Natl Vital Stat Rep 2007;56:1-103.
  3. Current evidence regarding periodontal disease as a risk factor in preterm birth. Ann Periodontol 2001;6:183-188.
  4. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004;104:777-783.
  5. Periodontal infection and preterm birth: results of a prospective study. J Am Dent Assoc 2001;132:875-880.
  6. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67 (10 Suppl):1103-1113.
  7. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol 2006;107:29-36.
  8. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS). Am J Obstet Gynecol 2010;202:147.e1-8.
  9. Potential pathogenic mechanisms of periodontitis associated pregnancy complications. Ann Periodontol 1998;3:233-250.
  10. Periodontal changes in pregnancy. J Periodontol 1965;36:209-217.
  11. Periodontal status during pregnancy. J Periodontol 1974;45:641-643.
  12. Gingivitis in pregnant women. A longitudinal clinical study. Odontol Revy 1971;22:65-84.
  13. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol 1998;3:206-212.
  14. Periodontal infections and preterm birth: early findings from a cohort of young minority women in New York. Eur J Oral Sci 2001;109:34-39.
  15. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002;81:58-63.
  16. Periodontal therapy may reduce the risk of preterm low birth weight in women with periodontal disease. J Periodontol 2002;73:911-924.
  17. Periodontal disease and preterm birth: Results of a pilot intervention study. J Periodontol 2003;74:1214-1218.
  18. Maternal periodontitis and prematurity. Part II: Maternal infection and fetal exposure. Ann Periodontol 2001;6:175-182.
  19. Systemic release of endotoxins induced by gentle mastication: Association with periodontitis severity. J Periodontol 2002;73:73-78.
  20. Transient bacteremia after dental procedures and other minor manipulations. Transfusion 1980;20:82-85.
  21. Maternal periodontal disease is associated with an increased risk for pre-eclampsia. Obstet Gynecol 2003;101: 227-231.
  22. Role of periodontitis in systemic health: spontaneous preterm birth. J Dent Educ 1998;62:852-858.
  23. Intrauterine infection and preterm delivery. N Engl J Med 2000;342:1500-1507.
  24. Developmental outcome of extremely preterm infants. Am J Perinatol 2000;17:57-61.
  25. Prevention of prematurity. A review of our activities during the last 25 years. J Perinat Med 1997;25:406-417.
  26. Predicting preterm birth: a cost-effectiveness analysis. Am J Obstet Gynecol 2000;182:1589-1598.
  27. Intergenerational and environmental factors influencing pregnancy outcomes. Ann Epidemiol 2000;10:475-476.
  28. Socioeconomic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 2000;14:194-210.
  29. The relationship between maternal weight gain in pregnancy, hemoglobin level, stature, antenatal attendance and low birth weight. Southeast Asian J Trop Med Public Health 1997;28:873-876.
  30. Infection, inflammation and the risk of cerebral palsy. Curr Opin Neurol 2000;13:133-139.
  31. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG 2006;113:135-143.
  32. Effect of periodontal treatment phase I on birth term and birth weight. J Indian Soc Pedod Prev Dent 2006;24:23-26.
  33. Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis. J Periodontol 2007;78:2095-2103.
  34. Treatment of periodontal disease and risk. N Engl J Med 2006;355:1885-1894.
  35. A meta-analysis. Am J Obstet Gyncol 2007;196:135-e1-7.
  36. Effects of periodontal therapy on rate of preterm delivery: a randomized controlled trial. Obstet Gynecol 2009;114:551-559.
  37. Treatment of periodontal disease during pregnancy. Obstet Gynecol 2009;114:1239-1248.
  38. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol 2005;76: 2144-2153.
  39. Recurrence risks of preterm delivery: Am J Obstet Gyncol 2007;196:576 e1-6.
  40. Effect of periodontal disease treatment during pregnancy on preterm birth incidence: a meta-analysis of randomized trials. Am J Obstet Gyncol 2009;200:225-232.
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