Periodontal disease and adverse pregnancy outcomes: is there an association?
Presented at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine, San Diego, CA, Jan. 27-30, 2009.
Received 20 November 2008; received in revised form 20 February 2009; accepted 10 March 2009.
Objective
We assessed the risk of adverse pregnancy outcomes (preterm birth [PTB], preeclampsia [PRE], fetal growth restriction [FGR], or perinatal death) in women with periodontal disease (PD) compared to those without.
Study Design
A multicenter prospective cohort study enrolled women from 3 sites between 6 and 20 weeks' gestation. The presence of PD was defined as periodontal attachment loss ≥ to 3 mm on 3 or more teeth. The primary binary composite outcome included PRE, PTB, FGR, or perinatal death. Multivariable logistic regression (MVLR) was used to control for confounders.
Results
Three hundred eleven patients with and 475 without PD were included. There was no association between PD and the composite outcome, PRE, or PTB in unadjusted analyses. There was no association between PD and the composite outcome (adjusted odds ratio [AOR], 0.81; 95% confidence interval [CI], 0.58-1.15; P = .24), preeclampsia (AOR, 0.71; 95% CI, 0.37-1.36; P = .30), or preterm birth (AOR, 0.77; 95% CI, 0.49-1.21; P = .25) after adjusting for relevant confounders.
Conclusion
Despite the body of literature suggesting an association between PD and adverse pregnancy outcomes in urban populations, this large prospective study failed to demonstrate an association.
aDepartment of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA
bDepartment of Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA
cUniversity of Pennsylvania School of Dental Medicine, Philadelphia, PA
dDepartment of Obstetrics and Gynecology, Washington University, St. Louis, MO
Reprints not available from the authors.
This research was supported by a Pennsylvania Department of Health Grant and an NIH T32 Training Grant.
Cite this article as: Srinivas SK, Sammel MD, Stamilio DM, et al. Periodontal disease and adverse pregnancy outcomes: is there an association? Am J Obstet Gynecol 2009;200:497.e1-497.e8.
ABSTRACT