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ObjectiveThe purpose of this study was to test whether treating periodontal disease (PD) in pregnancy will reduce the incidence of spontaneous preterm delivery (SPTD) at ≤35 weeks of gestation. Study DesignA multicenter, randomized clinical trial was performed. Subjects with PD were randomized to scaling and root planing (active) or tooth polishing (control). The primary outcome was the occurrence of SPTD at <35 weeks of gestation. ResultsWe screened 3563 subjects for PD; the prevalence of PD was 50%. Seven hundred fifty-seven subjects were assigned randomly; 378 subjects were assigned to the active group, and 379 subjects were assigned to the placebo group. Active treatment did not reduce the risk of SPTD at <35 weeks of gestation (relative risk, 1.19; 95% confidence interval [CI], 0.62–2.28) or composite neonatal morbidity (relative risk, 1.30; 95% CI, 0.83–2.04). There was a suggestion of an increase in the risk of indicated SPTD at <35 weeks of gestation in those subjects who received active treatment (relative risk, 3.01; 95% CI, 0.95–4.24). ConclusionTreating periodontal disease does not reduce the incidence of SPTD. a Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO b Department of Obstetrics and Gynecology, School of Medicine, University of Pennsylvania, Philadelphia, PA c Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia, PA d School of Dentistry, University of Pennsylvania, Philadelphia, PA e Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia, PA f Departments of Public Health and Obstetrics and Gynecology, Temple University, Philadelphia, PA g Virginia Commonwealth University, Richmond, VA h Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, PA
Supported in part by a Grant from the Pennsylvania Department of Health, by Grant number UL1-RR-024134 from the National Center for Research Resources, and by Grant P60 MD002256 from the National Center on Minority and Health Disparities (J.F.S.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. Cite this article as: Macones GA, Parry S, Nelson DB, et al. 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. PII: S0002-9378(09)02118-8 doi:10.1016/j.ajog.2009.10.892 © 2010 Published by Elsevier Inc.
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ABSTRACT
Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS)
Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS)
