Periodontal therapy does not improve preterm or low birth weight rates


Last Updated: 2010-12-31 17:50:24 -0400 (Reuters Health)

By Will Boggs MD

NEW YORK (Reuters Health) - Periodontal therapy of pregnant women does not reduce the rates of preterm or low birth weight (LBW) infants, a new meta-analysis shows.

"Clearly, periodontal disease is an important oral infection that must be always treated when diagnosed in order to promote oral health, but we cannot recommend it for pregnant women with the goal of reducing preterm births and low birth weight," Dr. Mariana Fampa Fogacci from Federal University of Rio de Janeiro, Brazil told Reuters Health in an email.

In light of the lack of consensus on the relationship between periodontitis and these outcomes in the literature, Dr. Fogacci and colleagues conducted a systematic review to investigate whether scientific evidence supports the hypothesis that periodontal therapy could have a preventive effect.

They included 10 randomized trials with preterm birth as the endpoint and four that looked at low birth weight.

As reported in the January issue of Obstetrics & Gynecology (available online now), the authors tested the association of periodontal therapy with these outcomes through separate meta-analyses based on varying definitions of periodontal disease and controlled for confounding factors.

Periodontal therapy was not associated with the risk of preterm birth in any of the following: four studies that defined periodontitis according to both probing depth and attachment loss; eight that controlled for multiparity; seven that controlled for previous preterm birth; six that controlled for genitourinary infection; or three that fulfilled all of the previous criteria.

Similarly, periodontal therapy did not influence the risk of low birth weight in four trials that controlled for multiparity; three trials that controlled for previous preterm birth; or two studies that controlled for multiparity, previous preterm birth, and genitourinary infection.

There was no evidence of heterogeneity in most meta-analyses, and there was no evidence of publication bias.

"Additional randomized clinical trials using similar follow-up periods and (a) standardized diagnosis of periodontal disease are needed to test the hypothesis that periodontal therapy can reduce preterm birth and low birth weight indices," the researchers conclude.

But in the meantime, Dr. Fogacci said, research that she and her colleagues are doing in the lab, and that they'll be submitting for publication, is "leading us to believe in no association of periodontitis and preterm birth / low birth weight rates."

SOURCE:http://link.reuters.com/fad44r

Obstet Gynecol 2011;117:153-165.



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