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

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 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