Periodontal therapy and risk for adverse pregnancy outcomes

Oliveira, Alcione Maria Soares Dutra; Oliveira, Peterson Antônio Dutra; Cota, Luís Otávio Miranda; Magalhães, Cláudia Silami de; Moreira, Allyson Nogueira; Costa, Fernando Oliveira

doi:10.1007/s00784-010-0424-8

Cited by 53 publications

(103 citation statements)

References 26 publications

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“…Although all studies described randomization, nine did not adequately describe the random sequence generation methods 3,5,7,12,15,16,17,18,19,20 and nine did not adequately describe allocation concealment 3,5,7,12,15,16,17,18,19,20 . Twelve studies did not use blinding methods for adjudication outcomes 3,5,6,7,12,13,14,15,16,17,18,19,20 . Four trials described a modified intention-to-treat analysis 3,6,13,15 .…”

Section: Characteristics Of Trials Participants and Interventionsmentioning

confidence: 99%

“…Preterm births < 37 weeks: a meta-analysis of 13 studies 3,5,6,7,12,13,14,15,16,17,18,19,20 showed that periodontal disease treatment during pregnancy had no significant effect on the overall rate of preterm birth (RR = 0.90, 95%CI: 0.68-1.19; p = 0.45; I 2 : 74%) (Figure 2). Low birth weight < 2,500g: a meta-analysis of nine studies 3,5,6,7,12,14,15,17,20 showed a weak association between periodontal disease treatment during pregnancy and decreases in low birth weight, with no significant effect (RR = 0.92, 95%CI: 0.71-1.20; p = 0.55; I 2 : 56%) (Figure 3).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…Low birth weight < 2,500g: a meta-analysis of nine studies 3,5,6,7,12,14,15,17,20 showed a weak association between periodontal disease treatment during pregnancy and decreases in low birth weight, with no significant effect (RR = 0.92, 95%CI: 0.71-1.20; p = 0.55; I 2 : 56%) (Figure 3).…”

Section: Effects Of Interventionsmentioning

confidence: 99%

“…The literature search yielded 62 potentially relevant publications, of which 13 were considered eligible for inclusion in this review ( Figure 1) 3,5,6,7,12,13,14,15,16,17,18,19,20 . Reviews of the reference lists 13 primary studies included in meta-analysis 28 studies excluded 11 reviews 9 news, letters, editorials, replays 4 nonrandomized 4 different outcomes yielded two further citations.…”

Section: Identification Of Eligible Trialsmentioning

confidence: 99%

“…The development of periodontitis involves the invasion of primarily Gram-negative bacteria through the periodontium, stimulating a chronic inflamma-tory response and forming pockets that become infected 5,6 . However, according to Oliveira et al 7 , non-surgical periodontal treatment during the second semester of gestation did not reduce the risk of preterm birth, low birth weight, or preterm low birth weight.…”

Section: Introductionmentioning

confidence: 99%

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Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

et al. 2012

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The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

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Section: Characteristics Of Trials Participants and Interventionsmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Effects Of Interventionsmentioning

confidence: 99%

Section: Identification Of Eligible Trialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

et al. 2012

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Association of Chlorhexidine Use and Scaling and Root Planing With Birth Outcomes in Pregnant Individuals With Periodontitis

et al. 2022

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ImportanceChlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking.ObjectiveTo assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes.Data SourcesCochrane Oral Health’s Trials Register, Cochrane Pregnancy and Childbirth’s Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database), US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov), and the WHO International Clinical Trials Registry Platform were searched through March 2022.Study SelectionRCTs were included if they were conducted among pregnant individuals with periodontitis, used interventions consisting of SRP vs no periodontal treatment, and assessed birth outcomes.Data Extraction and SynthesisData were abstracted with consensus of 2 reviewers using Rayyan and assessed for bias with the Cochrane Risk of Bias 2 tool before random effects subgroup meta-analyses. Analyses were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.Main Outcomes and MeasuresOutcomes of interest were preterm birth (ie, &lt;37 weeks’ gestation) and low birth weight (ie, &lt;2500 g).ResultsThere were 12 studies with a total of 5735 participants evaluating preterm birth. Control group participants did not receive any treatment or use chlorhexidine during pregnancy. All intervention group participants received SRP; in 5 of these studies (with 2570 participants), pregnant participants in the treatment group either received chlorhexidine mouthwash or advice to use it, but participants in the remaining 7 studies (with 3183 participants) did not. There were 8 studies with a total of 3510 participants evaluating low birth weight, including 3 studies with SRP plus chlorhexidine (with 594 participants) and 6 studies with SRP only (with 2916 participants). The SRP plus chlorhexidine groups had lower risk of preterm birth (relative risk [RR], 0.56; 95% CI, 0.34-0.93) and low birth weight (RR, 0.47; 95% CI, 0.32-0.68) but not the SRP-only groups (preterm birth: RR, 1.03; 95% CI, 0.82-1.29; low birth weight: RR, 0.82; 95% CI, 0.62-1.08).Conclusions and RelevanceThese findings suggest that treating maternal periodontitis with chlorhexidine mouthwash plus SRP was associated with reduced risk of preterm and low birth weight. Well-conducted RCTs are needed to test this hypothesis.

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Treating periodontal disease for preventing adverse birth outcomes in pregnant women

Iheozor‐Ejiofor

Middleton

Esposito

et al. 2017

Cochrane Database of Systematic Reviews

117

131

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Periodontal therapy and risk for adverse pregnancy outcomes

Cited by 53 publications

References 26 publications

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

Association of Chlorhexidine Use and Scaling and Root Planing With Birth Outcomes in Pregnant Individuals With Periodontitis

Treating periodontal disease for preventing adverse birth outcomes in pregnant women

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