Treatment of Periodontal Disease and the Risk of Preterm Birth
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- 2 November 2006
- journal article
- research article
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 355 (18), 1885-1894
- https://doi.org/10.1056/nejmoa062249
Abstract
Maternal periodontal disease has been associated with an increased risk of preterm birth and low birth weight. We studied the effect of nonsurgical periodontal treatment on preterm birth. We randomly assigned women between 13 and 17 weeks of gestation to undergo scaling and root planing either before 21 weeks (413 patients in the treatment group) or after delivery (410 patients in the control group). Patients in the treatment group also underwent monthly tooth polishing and received instruction in oral hygiene. The gestational age at the end of pregnancy was the prespecified primary outcome. Secondary outcomes were birth weight and the proportion of infants who were small for gestational age. In the follow-up analysis, preterm birth (before 37 weeks of gestation) occurred in 49 of 407 women (12.0%) in the treatment group (resulting in 44 live births) and in 52 of 405 women (12.8%) in the control group (resulting in 38 live births). Although periodontal treatment improved periodontitis measures (P<0.001), it did not significantly alter the risk of preterm delivery (P=0.70; hazard ratio for treatment group vs. control group, 0.93; 95% confidence interval [CI], 0.63 to 1.37). There were no significant differences between the treatment and control groups in birth weight (3239 g vs. 3258 g, P=0.64) or in the rate of delivery of infants that were small for gestational age (12.7% vs. 12.3%; odds ratio, 1.04; 95% CI, 0.68 to 1.58). There were 5 spontaneous abortions or stillbirths in the treatment group, as compared with 14 in the control group (P=0.08). Treatment of periodontitis in pregnant women improves periodontal disease and is safe but does not significantly alter rates of preterm birth, low birth weight, or fetal growth restriction. (ClinicalTrials.gov number, NCT00066131.)Keywords
This publication has 34 references indexed in Scilit:
- Cessation of periodontal care during pregnancy: effect on infant birthweightEuropean Journal of Oral Sciences, 2006
- Campylobacter rectus Mediates Growth Restriction in Pregnant MiceThe Journal of Periodontology, 2005
- A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcomeBritish Dental Journal, 2004
- Subantimicrobial dose doxycycline as adjunctive treatment for periodontitisJournal of Clinical Periodontology, 2004
- Incidence of periodontal attachment loss over 5 years among older South AustraliansJournal of Clinical Periodontology, 2004
- Meta‐Analysis of Local Tetracycline in Treating Chronic PeriodontitisThe Journal of Periodontology, 2003
- A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing RiskThe Annals of Statistics, 1988
- Salt and Peroxide Compared with Conventional Oral Hygiene: I. Clinical ResultsThe Journal of Periodontology, 1987
- Two years oral use of chlorhexidine in manJournal of Periodontal Research, 1976
- The Gingival Index, the Plaque Index and the Retention Index SystemsThe Journal of Periodontology, 1967