American Journal of Obstetrics & Gynecology
Volume 194, Issue 5 , Pages 1316-1322, May 2006

Maternal periodontal disease in early pregnancy and risk for a small-for-gestational-age infant

  • Kim A. Boggess, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine
    • Center for Oral and Systemic Diseases, University of North Carolina, Chapel Hill, NC
  • ,
  • James D. Beck, PhD

      Affiliations

    • Center for Oral and Systemic Diseases, University of North Carolina, Chapel Hill, NC
  • ,
  • Amy P. Murtha, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
  • ,
  • Kevin Moss

      Affiliations

    • Center for Oral and Systemic Diseases, University of North Carolina, Chapel Hill, NC
  • ,
  • Steven Offenbacher, DDS, PhD

      Affiliations

    • Center for Oral and Systemic Diseases, University of North Carolina, Chapel Hill, NC

Received 29 June 2005; received in revised form 29 November 2005; accepted 30 November 2005. published online 24 April 2006.

Objective

The objective of the study was to determine whether periodontal disease is associated with delivery of a small-for-gestational-age infant.

Study design

In a prospective study of oral health, periodontal disease was categorized as health, mild, or moderate/severe on the basis of clinical criteria. Small for gestational age was defined as birth weight less than the 10th percentile for gestational age. A risk ratio (95th percentile confidence interval) for a small-for-gestational-age infant among women with moderate or severe periodontal disease was calculated.

Results

Sixty-seven of 1017 women (6.6%) delivered a small-for-gestational-age infant, and 143 (14.3%) had moderate or severe periodontal disease. The small-for-gestational-age rate was higher among women with moderate or severe periodontal disease, compared with those with health or mild disease (13.8% versus 3.2% versus 6.5%, P < .001). Moderate or severe periodontal disease was associated with a small-for-gestational-age infant, a risk ratio of 2.3 (1.1 to 4.7), adjusted for age, smoking, drugs, marital and insurance status, and pre-eclampsia.

Conclusion

Moderate or severe periodontal disease early in pregnancy is associated with delivery of a small-for-gestational-age infant. Understanding the mechanism of periodontal disease–associated adverse pregnancy outcomes could lead to interventions to improve fetal growth.

Key words: Pregnancy, Periodontal disease, Small-for-gestational-age

 

 Supported by National Institutes of Health Grants K08 HD043284 and R01 DE12453 and the University of North Carolina General Clinical Research Center Grant RR00046.Reprints not available from the authors.

PII: S0002-9378(05)02679-7

doi:10.1016/j.ajog.2005.11.059

American Journal of Obstetrics & Gynecology
Volume 194, Issue 5 , Pages 1316-1322, May 2006