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The Risk of Preterm Birth in Women With Periodontitis: A Systematic Review and Meta-Analysis
Dimitris Sokos1, Dagmar Else Slot1, Berna Dogan1
1Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
International Journal of Dental Hygiene
|October 3, 2025
Summary
Pregnant women with periodontitis face a small, but statistically significant, increased risk of preterm birth (PTB). This meta-analysis confirms a link between gum disease and premature delivery.
Area of Science:
- Periodontology and Obstetrics
- Maternal Health Research
- Public Health Epidemiology
Background:
- Conflicting evidence exists regarding the association between periodontitis and preterm birth (PTB).
- Methodological variations and differing case definitions have complicated previous research.
- This study addresses the need for a critical synthesis of observational evidence.
Purpose of the Study:
- To evaluate the risk of PTB in pregnant women with periodontitis compared to those without.
- To critically synthesize available scientific evidence from observational studies.
- To provide a robust analysis using meta-analysis and trial sequential analysis.
Main Methods:
- Searched MEDLINE-PubMed and Cochrane databases up to June 2025.
- Included studies with periodontitis defined by clinical examination (probing depth, attachment loss) and/or radiographic bone loss.
- Conducted descriptive analysis, meta-analysis (MA), and trial sequential analysis (TSA), with sub-analyses for confounding factors.
Main Results:
- Eleven eligible studies were included from 723 identified papers.
- Seven studies showed a significant association between periodontitis and PTB.
- Meta-analysis revealed a small effect (OR: 2.38 [95% CI: 1.78; 3.18]), with TSA confirming statistical significance and ruling out type I error.
Conclusions:
- There is moderate certainty of an increased risk of PTB in pregnant women with periodontitis.
- The identified risk, while small, is statistically significant and supported by robust analysis.
- Findings highlight the importance of addressing periodontitis in prenatal care.
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