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Periodontal infection as a possible risk factor for preterm low birth weight
S Offenbacher1, V Katz, G Fertik
1Department of Periodontics, School of Dentistry, University of North Carolina at Chapel Hill, USA.
Insights
Maternal periodontal disease significantly increases the risk of preterm low birth weight (PLBW). This oral infection is a major risk factor for adverse pregnancy outcomes, even after accounting for other risk factors.
Area of Science:
- Obstetrics and Gynecology
- Periodontology
- Public Health
Background:
- Periodontal diseases are common gram-negative anaerobic infections in women of childbearing age.
- The association between maternal periodontal infection and adverse birth outcomes like preterm low birth weight (PLBW) requires further investigation.
Purpose of the Study:
- To determine if maternal periodontal infection is associated with preterm low birth weight (PLBW).
- To control for known risk factors and covariates in assessing this association.
Main Methods:
- A case-control study involving 124 pregnant or postpartum mothers.
- PLBW cases defined by birth weight < 2,500g and gestational age < 37 weeks, preterm labor (PTL), or premature rupture of membranes (PROM).
- Periodontal examinations and assessment of obstetric risk factors including tobacco, drug, alcohol use, prenatal care, parity, genitourinary infections, and nutrition.
Main Results:
- PLBW cases, particularly primiparous PLBW cases, exhibited significantly worse periodontal disease compared to normal birth weight (NBW) controls.
- Multivariate logistic regression revealed periodontal disease as a significant risk factor for PLBW (adjusted odds ratios 7.9 for all PLBW, 7.5 for primiparous PLBW).
Conclusions:
- Maternal periodontal disease is a significant and previously unrecognized risk factor for preterm low birth weight.
- Periodontal infection may contribute to adverse pregnancy outcomes such as PTL or PROM.
Abstract:
Peridontal diseases are gram-negative anaerobic infections that can occur in women of childbearing age (18 to 34 years). In the present investigation we sought to determine whether the prevalence of maternal periodontal infection could be associated with preterm low birth weight (PLBW), controlling for known risk factors and potential covariates. A case-control study of 124 pregnant or postpartum mothers was performed. PLBW cases were defined as a mother with a birth of less than 2,500 g and one or more of the following: gestational age < 37 weeks, preterm labor (PTL), or premature rupture of membranes (PROM). Controls were normal birth weight infants (NBW). Assessments included a broad range of known obstetric risk factors, such as tobacco use, drug use, alcohol consumption, level of prenatal care, parity, genitourinary infections, and nutrition. Each subject received a periodontal examination to determine clinical attachment level. PLBW cases and primiparous PLBW cases (n = 93) had significantly worse periodontal disease than the respective NBW controls. Multivariate logistic regression models, controlling for other risk factors and covariates, demonstrated that periodontal disease is a statistically significant risk factor for PLBW with adjusted odds ratios of 7.9 and 7.5 for all PLBW cases and primiparous PLBW cases, respectively. These data indicate that periodontal diseases represent a previously unrecognized and clinically significant risk factor for preterm low birth weight as a consequence of either PTL or preterm PROM.