Assessing the association between periodontitis and premature birth: a case-control study

Abstract

Background Premature delivery is among the leading causes of perinatal mortality and morbidity in developed societies, which is an important obstetrics problem. Maternal periodontitis is a prevalent condition that has been suspected to be associated with adverse pregnancy outcomes such as premature birth. However, there are still conflicting results about this possible relationship, therefore this study was designed to test the association between maternal periodontitis and premature birth. This study also provides information about a new screening tool recommended for use by nurses and midwives to screen for periodontal diseases during antenatal consultations in order to improve the health of mothers and children. Methods A retrospective case-control study was conducted at 12 health facilities in the Southern Province of Rwanda from February to August, 2018. A total of 555 women in the postpartum period were enrolled in the study. Cases and controls were enrolled in a ratio of 1:2; each enrolled case of preterm birth was followed by 2 unmatched control subjects that were next on the register and who delivered at term gestation. A total of 185 cases of preterm deliveries and 370 controls of term delivery were enrolled in the study. Multivariate regression analysis was used and the independent variables were hierarchically entered in three groups: The first group involved demographic variables that were put in the regression model as Step 1. The second group was made up of other potential risk factors that were placed in the regression model as the second step. Periodontitis was entered in the final regression step, as it was hypothesized as the main predictor variable. Results A statistically significant association was found between periodontitis and premature birth. Women who had periodontitis had 6 times the odds of giving birth to premature birth infants compared to women who had no periodontitis (OR: 6.360, 95% CI 3.9, 10.4). Conclusion The study results indicate that periodontitis is strongly associated with premature birth. Preventive solutions including the use of a periodontitis screening tool for nurses and midwives during antenatal care consultations, are highly recommended.

A Scoping Review of Preterm Births in Sub-Saharan Africa: Burden, Risk Factors and Outcomes

“…Anaemia in pregnancy was also reported to be associated with increased odds of PTB in eight of the included studies [ 18 , 19 , 49 , 56 , 63 , 76 , 77 , 108 ], with the risk of PTB increasing with its severity [ 56 ]. Other infections or conditions in pregnancy that were reported to increase the burden of PTB were bacterial vaginosis [ 105 ], tuberculosis [ 84 ], diabetes [ 108 ], depression [ 78 ], urinary and reproductive tract infections [ 39 , 71 , 90 , 104 ], opportunistic infections [ 47 ], and periodontal disease [ 26 , 51 , 100 ].…”

The Association between Maternal Periodontitis and Preterm Birth: A Case-Control Study in a Low-Resource Setting in Sudan, Africa

“…The main finding of the current study was that women with periodontitis were at 2.05 times higher risk for PB. Previous studies have shown that women who had periodontitis were at 6.3 and 2.3 times higher risk for PB in Uganda and Tanzania, respectively [ 9 , 10 ]. A recent (2021) review, which included 232 articles and 119,774 women, reported a statistically significant association between periodontal diseases and PB [ 11 ].…”

“…Vast data has recently been published on the association between periodontitis and PB [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. However, these studies have shown inconsistent results, while some have shown that periodontitis was associated with PB [ 11 , 12 , 13 , 14 ].…”

“…Other studies have failed to show a significant association between periodontitis and PB [ 15 , 16 , 17 , 18 ]. Moreover, few of them were conducted in Africa [ 9 , 10 ], and no data has been published in Sudan on the association between periodontitis and PB. Perhaps the associations between periodontitis and PB in Sub-Saharan Africa, including Sudan, are influenced by other covariates such as anaemia, which is widely prevalent among pregnant women in Africa [ 19 ].…”

Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies

“…Both a meta-analysis and a cohort study showed that, compared with pregnant women without periodontitis, pregnant women with periodontitis had a doubled risk of preterm birth ( 14 , 15 ). Similarly, a retrospective case-control study enrolling 555 postpartum women found that pregnant women with periodontitis were six times more likely to deliver premature babies than women without periodontitis ( 16 ). Likewise, a hospital-based cross-sectional case-control study suggested that the presence of postpartum maternal periodontitis and its severity remained independent risk factors for preterm birth in the presence of antepartum smoking habits and routes of delivery ( 17 ).…”