Pregnant women with periodontal disease (PD) may be at increased risk for having preterm low-birth-weight (PLBW) children. We investigated whether the maintenance of the mothers’ periodontal health after 28 weeks’ gestation reduces the risk of PLBW. Of the 639 women studied, 406 had gingivitis and received treatment before 28 weeks’ gestation, and 233 had PD and were treated after delivery. Data about previous and current pregnancies and known risk factors were obtained from patients’ medical records. Primary outcomes were delivery before 37 weeks’ gestation or an infant with birth weight below 2500 g. The incidence of PLBW was 2.5% in periodontally healthy women, and 8.6% in women with PD (p = 0.0004, relative risk = 3.5, 95% CI, 1.7 to 7.3). Risk factors significantly associated with PLBW were previous PLBW, PD, fewer than 6 prenatal visits, and low maternal weight gain. PD was associated with both preterm birth and low birth weight, independent of other risk factors.
AbramsB., NewmanV., KeyT., ParkerJ. (1989). Maternal weight gain and preterm delivery.Obstet Gynecol74: 577–583.
2.
BeckmanI., Meise-MikolajczyF., LeszczynskyP., BrooijmansM., WallenburgH.C.S. (1993). Endotoxin-induced fetal growth retardation in the pregnant guinea pig.Am J Obstet Gynecol168: 714–718.
3.
BerkowitzG.S., PapiernikE. (1993). Epidemiology of preterm birth.Epidemiol Rev15: 414–443.
4.
CarmichaelS.L., AbramsB. (1997). A critical review of the relationship between gestational weight gain and preterm delivery.Obstet Gynecol89: 866–873.
5.
de HassI., HarlowB.L., CramerD.W., FrigolettoF.D.Jr (1991). Spontaneous preterm birth: a case-control study.Am J Obstet Gynecol165: 1290–1296.
6.
DonaldsonP.J., BillyJ.O.G. (1984). The impact of prenatal care on birth weight: evidence from an international data set.Med Care22: 177–188.
7.
FinkA., YanoE.M., GoyaD. (1992). Prenatal programs: what the literature reveals.Obstet Gynecol80: 567–572.
8.
FiscellaK. (1995). Does prenatal care improved birth outcomes? A critical review.Obstet Gynecol85: 468–479.
9.
GreenbergR.S. (1983). The impact of prenatal care in different social groups.Am J Obstet Gynecol145: 797–801.
10.
GuickD.S., DaikokuN.H., KaltreiderD.F. (1984). Predictability of pregnancy outcome in preterm delivery.Obstet Gynecol63: 645–650.
11.
GuinnD.A., GoldenbergR.L., HauthJ.C., AndrewsW.W., ThomE., RomeroR. (1995). Risk factors for the development of premature rupture of the membranes after arrest of preterm labor.Am J Obstet Gynecol173: 1310–1315.
12.
HedigerM.L., SchollT.O., BelskyD.H., AncesI.G., SalmonW.R. (1989). Patterns of weight gain in adolescent pregnancy: effects on birth weight and preterm delivery.Obstet Gynecol74: 6–12.
13.
HoistE., GoffengA.R., AnderschB. (1994). Bacterial vaginosis and vaginal microorganisms in idiopathic premature labor and association with pregnancy outcome.J Clin Microbiol32: 176–186.
14.
JeffcoatM.K., GeursN.C., ReddyM.S., LiverS.P., GoldenbergR.L., HauthJ.C. (2001). Periodontal infection and preterm birth. Results of a prospective study.J Am Dent Assoc132: 875–880.
15.
KierseM.J. (1989). An evaluation of formal risk scoring for preterm birth.Am J Perinat6: 226–233.
16.
KramerM.S. (1987). Determinants of low birth weight: methodological assessment and meta-analysis.Bull World Health Org65: 663–737.
17.
Mitchell-LewisD., EngebretsonS.P., ChenJ., LamsterI.B., PapapanouP.N. (2001). Periodontal infections and preterm birth: early findings from a cohort of young minority women in New York.Eur J Oral Sci109: 34–39.
18.
OffenbacherS., KatzV., FertikG., CollinsJ., BoydD., MaynorG.. (1996). Periodontal infection as a possible risk factor for preterm low birth weight.J Periodontol67: 1103–1113.
PaigeD.M., AugustynM., AdihW.K., WitterF., ChangJ. (1998). Bacterial vaginosis and preterm birth: a comprehensive review of the literature.J Nurse Midwifery43: 83–89.
21.
QuickJ.D., GreenlickM.R., RoghmannK.J. (1981). Prenatal care and pregnancy outcome in an HMO and general population: a multivariable cohort analysis.Am J Public Health71: 381–390.
22.
RomeroR., MazorJ. (1988). Infection and preterm labor.Clin Obstet Gynecol31: 553–584.
23.
RomeroR., HobbinsJ.C., MitchellM.D. (1988). Endotoxin stimulates PGE2 production by human amnion.Obstet Gynecol71: 227–228.
24.
RomeroR., MazorM., WuY.K., AvilaC., OyarzunE., MitchellM.D. (1989). Bacterial endotoxin and tumor necrosis factor stimulate prostaglandin production by human decidua.Prost Leukotr Essent Fatty Acids337: 183–186.
ShapiraL., SoskolneW.A., SelaM.N., OffenbacherS., BarakV. (1994). The secretion of PGE2, IL-1 beta, II-6, and TNF alpha by adherent mononuclear cells from early onset periodontitis patients.J Periodontol65: 139–146.
27.
ShionoP.H., KlebanoffM.A., RhoadsC.G. (1986). Smoking and drinking during pregnancy.J Am Med Assoc255: 82–84.
28.
SokolR.J., WoolfR.B., RoseM.G., WeingardenK. (1980). Risk, antepartum care, and outcome: impact of a maternity and infant care project.Obstet Gynecol56: 150–156.
29.
United States General Accounting Office (1987). Prenatal care: Medicaid recipients and uninsured women obtain insufficient care.Washington, DC: General Accounting Office.
30.
WenS.W., GoldenbergR.L., CutterG.R., HoffmanH.J., CliverS.P. (1990). Intrauterine growth retardation and preterm delivery: prenatal risk factors in an indigent population.Am J Obstet Gynecol162: 213–218.
31.
World Health Organization (1984). The incidence of low birth weight—an update.Weekly Epidemiol Rec59: 205–211.
