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Updated: Aug 29, 2026

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Published on: February 16, 2024
The oral microbiome in relation to systemic maternal conditions and pregnancy complications: a systematic review and
Jiawei Xu1, Cong Li1, Weifen Wu1
1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Zhejiang Key Laboratory of Oral Biomedical, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
Background:
Alterations in the oral microbiome have been associated with systemic diseases, but evidence regarding maternal conditions and pregnancy complications remains limited. This systematic review evaluated these associations.
Methods:
PubMed, Web of Science, and Embase were searched for studies using high-throughput sequencing to profile the oral microbiome in pregnant women with systemic diseases or adverse pregnancy outcomes. Random-effects meta-analyses were performed for alpha diversity indices, while methodological heterogeneity precluded quantitative synthesis of beta diversity and taxonomic abundance.
Results:
Twenty-four studies were included, with 11 contributing to the meta-analysis. Gestational diabetes mellitus (GDM) was associated with lower Observed richness (SMD = -0.29, 95% CI: -0.55 to -0.03), whereas low birth weight (LBW) was associated with higher Chao1 (SMD = 0.46, 95% CI: 0.03-0.88). No significant alpha diversity differences were observed for pre-eclampsia or preterm birth. Differences in beta diversity and taxonomic abundance were reported across several conditions, although findings were heterogeneous.
Conclusions:
Oral microbial richness may be associated with GDM and LBW, but associations with other pregnancy complications remain uncertain. Standardized, large-scale prospective studies are needed.
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