Periodontal Disease And Risk For Pre-Term Birth: A Case-Control Study

Maternal periodontal infection has been recognizsed as a risk factor for preterm and low birth weight infants. It is hypothesized that pathogens causing periodontal disease might translocate to the amniotic cavity and contribute to triggering an adverse pregnancy outcome. The growing evidence that an infection remote from the foetal-placental unit might have a role in preterm delivery has led to an increased awareness of the potential role of chronic bacterial infections in the body. The aim of this study was to evaluate whether the presence of chronic periodontitis might influence the incidence of preterm labour and preterm birth.

This study was designed as a hospital-based case-control study. Seventy pregnant women aged 18-40 years, with a single live pregnancy were recruited from the Department of Gynaecology and Obstetrics of a general hospital in Sibenik, Croatia, from March 2013 to March 2014.

The case group included: 30 pregnant women who were hospitalized with signs of preterm labour. The control group included 40 normal pregnancy patients, who were analysed for up to 48 h after the delivery of a term baby having a birth weight of more than 1500 g. A full-mouth periodontal examination was performed on all the patients. Information was collected on the demographics, health behaviours, and obstetric and systemic diseases that might have an influence in preterm delivery.

The presence of chronic periodontitis tended to be higher in women with a preterm delivery (the case group), with 20 cases (66%), than in the women in the, control group, in which chronic periodontitis was found in 14 cases (35%); this difference reached statistical significance (p≤0.01). The PTB cases had a significantly worse periodontal status than the controls (p≤0.001). From the PTL group, 18 patients delivered preterm, and chronic periodontitis, found in 15 cases (83%), was more prevalent than in the control group. The risk of women having periodontitis or attachment loss ≥ 4 mm developing PTB showed an OR of 3.7 (95% CI: 1.91 to 4.86; P< 0.001).

The study shows a significant association between periodontal chronic disease and an adverse pregnancy outcome. Periodontal disease represents a strong, independent risk factor for preterm births, and periodontal prevention and therapy should be a part of preventive prenatal care.