Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews

Abstract

Periodontal disease is very common during pregnancy. Although it has been linked to adverse pregnancy outcomes, systematic reviews have reached discrepant conclusions on these links. Therefore, we conducted a systematic overview of systematic reviews studying the association between periodontal disease and adverse pregnancy outcomes. We searched 6 online databases up to November 2016 and hand-searched references and citations of eligible papers. Systematic reviews of studies comparing pregnancy outcomes among women with and without periodontal disease were eligible for inclusion. Primary outcomes were maternal mortality, preterm birth, and perinatal mortality. Two reviewers extracted data and assessed risk of bias of individual systematic reviews. Findings are described in tabular and narrative form. Twenty-three systematic reviews (including between 3 and 45 studies) were included. None reported the association between periodontal disease and maternal or perinatal mortality. Systematic reviews with the lowest risk of bias consistently demonstrated positive associations between periodontal disease and preterm birth (relative risk, 1.6; 95% confidence interval, 1.3 to 2.0; 17 studies, 6,741 participants), low birth weight (LBW; relative risk, 1.7; 95% CI, 1.3 to 2.1; 10 studies, 5,693 participants), preeclampsia (odds ratio, 2.2; 95% CI, 1.4 to 3.4; 15 studies, 5,111 participants), and preterm LBW (relative risk 3.4; 95% CI, 1.3 to 8.8; 4 studies, 2,263 participants). Based on these figures, estimated population-attributable fractions for periodontal disease were 5% to 38% for preterm birth, 6% to 41% for LBW, and 10% to 55% for preeclampsia. In terms of limitations, as several primary studies did not adjust for confounding, meta-analyses may have overestimated the strength of the associations under study. Due to substantial overlap in included primary studies, we could not aggregate results across reviews. Consistent evidence from systematic reviews with low risk of bias indicates that pregnant women with periodontal disease are at increased risk of developing preeclampsia and delivering a preterm and/or LBW baby (PROSPERO: CRD42015030132).Knowledge Transfer Statement: This study highlights that periodontal disease is an important risk factor for several common adverse pregnancy outcomes. Clinicians should be aware of this link to guide risk selection. Research is needed to develop novel preventive and treatment strategies.

Fast Track to Teledentistry: Removing Barriers to Care While Maximizing Care

“…In addition, researchers have reported that "uncontrolled periodontal disease could trigger or exacerbate" the neuroinflammatory phenomenon seen in Alzheimer's disease 16 . Preterm births and other adverse outcomes of pregnancy are also associated with periodontal disease 17 .…”

Importance of heterogeneity in Porhyromonas gingivalis lipopolysaccharide lipid A in tissue specific inflammatory signalling

“…P. gingivalis has been associated with adverse pregnancy outcomes (APOs) [64,65]. A hemin-rich medium promotes the growth of TLR4 antagonist forms of P. gingivalis [25].…”

Differences of Maternal Sociodemographic Characteristics With Spontaneous Preterm Birth Among Hospitals in Indonesia: A Comparative Study

“…Periodontal infection, indicated that the average periodontal infection of preterm birth was significantly different among hospitals, i.e., mothers who have experienced periodontal infection have an average of 13 mothers per hospital, with the largest number being in Airlangga Hospital that was 24 mothers (17.9%) and mothers who had never experienced periodontal infections had an average of 3 mothers per hospital, with the highest number in Sidoarjo Hospital, by 10 mothers (7.5%). According to Daalderop et al, (2017) based on reverage result his review for periodontal disease was 5% -38% for preterm birth and 6%-41% for LBW. Although according to Sutherland et al, (2017) that periodontal treatment did not affect preterm birth, so this study only gave different perondontal infection among hospitals, and not after given treatmeant during pregnancy.…”